56-year-old male with history of renal cancer and pelvic mass. Please compare with previous MRI done 4/2016. ABDOMEN:LIVER, BILIARY TRACT: No focal lesion or biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post left nephrectomy. Again noted are several enhancing soft tissue nodules in the left dorsal lateral retroperitoneal space (axial series 14 images 142, 137, 134).The largest nodule measures 3 x 1 cm (axial series 15 image 50), unchanged.Another discrete nodule more inferiorly measures 0.8 cm (axial series 15 image 39), unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval enlargement of the previously described peripherally enhancing lesion anterior to the spleen in the left upper quadrant measuring 4.1 x 4 cm (axial series 14 image 259), previously measured as 2.1 x 1.9 cm.BONES, SOFT TISSUES: Similar appearing 2 x 1 cm enhancing nodularity of the lower left lateral abdominal wall musculature (axial series 14 image 200).OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Minimal persistent wedge-shaped focus of enhancement within the left lateral gluteus maximus muscle (axial series 4 image 76). No evidence for pelvic mass.OTHER: No significant abnormality noted.
1.Increased size of the rim-enhancing mesenteric lesion anterior to the spleen measuring 4.1 x 4 cm (prior 2.1 x 1.9 cm) and is again highly suspicious for a necrotic metastatic focus.2.Status post left nephrectomy with similar appearing enhancing soft tissue nodularity in the left retroperitoneum suspicious for residual/recurrent disease. Not significantly changed.3.Additional nonspecific enhancing soft tissue nodule in the left lateral abdominal wall musculature is also not significantly changed and may represent another site of metastatic disease.