Male 81 years old with metastatic renal cell carcinoma. Evaluate for progression. ABDOMEN:LIVER, BILIARY TRACT: Normal morphology liver. Bilobar T2 hyperintense hepatic lesions are redemonstrated with reference measurements provided below. The segment 6 lesion has more nodular contrast enhancement than on the previous exam. A nonreference segment 5 lesion is demonstrates progressive peripheral, nodular discontinuous enhancement compatible with hemangioma. No new lesions are identified. Reference measurements are provided below.The hepatic vasculature is patent. No intra or extrahepatic biliary ductal dilatation. The gallbladder is normally distended.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Status post right adrenalectomy.KIDNEYS, URETERS: Status post right nephrectomy. The left upper pole complex cystic lesion has dense calcification (as seen on same day CT) and is unchanged. Several other simple cysts in the left kidney are stable. No suspicious left renal lesion.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Levoscoliosis and degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted.INDEX LESION MEASUREMENTS (Current exam date/time: 12/13/2016 10:30:00)SEGMENT 8 LESION: 3.5 x 2.6 cm (Image 204, Series 10); 3.7 x 3.0 cm on prior (8/30/2016) (Image 28, Series 1200).SEGMENT 2 LESION: 1.6 x 1.6 cm (Image 192, Series 10); 2.2 x 2.0 cm on prior (8/30/2016) (Image 28, Series 1200).SEGMENT 6 LESION: 3.5 x 3.4 cm (Image 179, Series 10); 2.7 x 3.2 cm on prior (8/30/2016) (Image 46, Series 1200).
1.Interval decrease in the size of reference segment 2 and 8 hepatic lesions. The reference lesion in segment 6 has increased in size and demonstrates increased nodular enhancement.2.No new sites of disease.