63-year-old male patient with HCC status post TACE/RFA. Assess liver lesion. ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology of the liver with interstitial T2 hyperintensity compatible with fibrosis.There is a segment 3 ablation cavity measuring approximately 2.5 x 1.7 cm (image 273, series 10). There is increasing marginal enhancement about the left aspect of the ablation cavity with a more nodular enhancing focus anteriorly (image 49, series 10). Scattered peripheral arterially enhancing foci without washout may be perfusional in etiology.Stable hepatic cysts in the right hepatic lobe. Cholelithiasis within a contracted gallbladder. Trace perihepatic fluid. SPLEEN: Splenomegaly with the spleen measuring 22 cm in the craniocaudal dimension. Recanalized periumbilical vein.PANCREAS: There are numerous cystic pancreatic foci which appear to communicate with the main pancreatic duct, appearing similar to the prior study. A reference proximal pancreatic tail cystic lesion measures 1.2 x 1.0 cm (image 34, series 7), previously 1.2 x 0.9 cm. There are no suspicious enhancing features. The main pancreatic duct is mildly prominent in the distal body and tail, unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate hyperintensities in both kidneys are too small to characterize, unchanged and likely benign cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Gastroesophageal and retroperitoneal varices. BONES, SOFT TISSUES: Mild bilateral gynecomastia. OTHER: A subpleural nodule within the right lower lobe is better characterized on prior CT chest.
1.Increasing marginal enhancement about the segment 3 ablation cavity. Residual/recurrent disease is not excluded; correlate with liver markers. 2.Cirrhotic morphology of the liver with fibrosis and stigmata of portal hypertension.3.Stable appearance of multiple cystic pancreatic lesions likely representing sidebranch IPMNs. 