History of IVC sarcoma status post resection 10/8/2014 ABDOMEN:LIVER, BILIARY TRACT: The previously described nonspecific focus in segment 8 now demonstrates a peripheral rim of enhancement and measures approximately 1.0 cm with associated restricted diffusion, highly suspicious for metastatic disease. Additionally there is a new punctate enhancing focus in the more peripheral aspect of segment 8. There are several additional punctate foci of restricted diffusion with associated T2-weighted mild hyperintensity and abnormal postcontrast enhancement (series 4 image 75, 77, and 80) in segment 4A and 7. Stable left hepatic lobe subcentimeter hemangioma. SPLEEN: The spleen is normal in size and morphology without a focal lesion.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: The punctate focus of restricted diffusion along the anterior aspect of the crus of the right hemidiaphragm is unchanged. The mildly enhancing soft tissue surrounding this focus is difficult to accurately measure and is not significantly changed (series 9, image 152).The low-density focus along the right posterolateral margin of the IVC is nonenhancing and likely represents postsurgical fluid, unchanged.No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Abdominal wall postsurgical changes.OTHER: No significant abnormality noted.
Increasing size of previously noted liver lesion and several new punctate liver lesions as described are suspicious for metastatic disease. Stable postsurgical changes of the resection bed.