History of renal cancer status post left nephrectomy, evaluate nodules in renal bed and left lower quadrant. Motion artifact on several of the sequences makes assessment suboptimal.ABDOMEN:LIVER, BILIARY TRACT: The liver is normal in morphology, size and signal intensity without a 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. In the adjacent dorsolateral retroperitoneal space there are several soft tissue nodules that demonstrate postcontrast enhancement, the largest conglomeration of which measures 2.5 x 1.4 cm (series 21, image 255), not significantly changed in size compared to 9/3/2015 where it measured 2.5 x 1.4 cm but slightly increased in size from 5/27/2015 outside MRI where it measured 2.2 x 1.1 cm (series 12 image 31). Another discrete nodule more inferiorly measures 8 mm (series 21, image 59), unchanged from 8 mm previously. There is a discrete parasplenic implant on the left lateral transversalis fascia (series 29, image 131), not significantly changed.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: In the lower left lateral abdominal wall musculature there is a 1.8 x 1.0 cm enhancing nodule (series 21, image 191), not significantly changed.OTHER: No significant abnormality noted.
1.Status post left nephrectomy with enhancing soft tissue nodularity in left retroperitoneal compartment suspicious for residual or locally recurrent disease, not significantly changed compared to 9/3/2015 but slightly increased in size from 5/27/2015 outside MRI. 2.Additional nonspecific enhancing soft tissue nodule in the left lateral abdominal wall musculature may also represent a site of metastatic disease, not significantly changed. 3.Additional nonspecific signal abnormality and enhancement in the insertion of the left gluteus maximus muscle which could represent inflammation or an additional site of metastatic disease, and continued attention to this area on follow-up imaging is recommended.