Reason: Pt with bordeline resectable HOP cancer. Pt has been on Folfirinox. Had restaging Ct Scan on 4/28/15.. Pt has a segment 7 liver lesion. Please evalaute prior to a whipple surgery History: weight loss. ABDOMEN:LIVER, BILIARY TRACT: Common bile duct stent in place. No intrahepatic or extrahepatic biliary ductal dilatation. Previously identified segment 7 subcentimeter lesion is seen on image 35, series #8. The lesion measures 3 mm in diameter. There is a second similar lesion in segment 7, best seen on image #29, series #8 measuring 3 mm. These lesions are best seen on pre and postcontrast T1-weighted images. These are too small to accurately characterize, however, they do not demonstrate rim enhancement. SPLEEN: No significant abnormality noted.PANCREAS: Hypoenhancing pancreatic head mass is unchanged, measuring approximately 4.1 x 3.3 cm (series 106 image 55). Abutment of the portal vein and SMV again noted. No pancreatic ductal dilatation. Enlarged portacaval lymph node is unchanged, measuring 1.7 x 1.4 cm (series 10 image 151). The mass invades the antrum.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Stable pancreatic head mass invading the stomach compatible with history of pancreatic cancer and regional lymphadenopathy.2.Two subcentimeter lesions measuring 3 mm in segment 7 of the liver. They cannot be accurately characterized, however, no evidence of peripheral rim enhancement to make them suspicious for metastatic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.