55-year-old male with history of necrotic tumor of transverse colon causing duodenal outlet obstruction. Evaluate for possible left renal vein thrombosis/invasion. ABDOMEN:LIVER, BILIARY TRACT: Status post right hepatectomy. No suspicious hepatic lesions. No hepatic steatosis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable moderate left-sided hydronephrosis. The known large peripherally enhancing centrally necrotic tumor arising from the transverse colon is again seen to invade the left lower renal pole parenchyma. Nonenhancing intraluminal thrombus expanding the left renal vein (axial series 9 image 34) is in direct continuity with the colonic mass and is felt to represent tumor invasion.RETROPERITONEUM, LYMPH NODES: Stable size of mildly enlarged left retroperitoneal lymph node (axial series 9 image 21).BOWEL, MESENTERY: Large peripherally enhancing and centrally necrotic tumor arising from the transverse colon is better evaluated on the prior CT exam. No significant interval change. Interval decompression of the stomach, however there is persistent dilatation of the first and second portion duodenum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Thrombus expanding the left renal vein is in direct continuity with the known colonic mass is favored to represent tumor invasion.2.Stable findings of a large necrotic tumor arising from the transverse colon again invading the left renal parenchyma and causing proximal dilatation of the duodenum. Stable mildly enlarged left retroperitoneal lymph node.