37 year-old female with metastatic rectal cancer. Please evaluate extent of disease status post chemo/radiation. CHEST:LUNGS AND PLEURA: No significant abnormality noted. No suspicious nodules, masses, or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size normal without pericardial effusion.Anterior mediastinal soft tissue is again likely represents residual thymic tissue.CHEST WALL: Right chest port catheter with catheter tip near SVC/RA junction. ABDOMEN: LIVER, BILIARY TRACT: Hypoattenuating lesion in segment 7 (series 5, image 81) has decreased in size since prior study, currently measuring 0.9 x 0.9 cm; previously measuring 1.4 x 2 cm.Portal and hepatic vasculature are patent. No intra- or extrahepatic biliary ductal dilatation.New submucosal edema in the gallbladder with increased mucosal enhancement, possibly representing sequela chemotherapy. No pericholecystic fluid.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable left adrenal thickening.KIDNEYS, URETERS: Right pelvic kidney.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Interval decrease in size of pelvic lymphadenopathy with reference right external iliac chain lymph node (series 5, image 168) measuring 1.1 x 1.3 cm; previously measuring 1.6 x 2 cm.Enlarged perirectal lymph node (series 5, image 164) measures 1.2 x 1.7 cm; previously measuring 1.7 x 2 cm.BOWEL, MESENTERY: Previously seen rectal wall thickening correlating with patient's known rectal cancer is no longer discretely visualized and therefore is not adequately measurable. Some mild residual rectal wall thickening seen on series 5, image 175 likely represents site of known cancer.BONES, SOFT TISSUES: Mild degenerative changes of the lumbar spine with chronic-appearing superior endplate depression at L4, unchanged.
1. Previously seen rectal mass is no longer discretely visualized.2. Interval decrease in size of liver metastasis and pelvic lymphadenopathy.3. New submucosal edema in the gallbladder with increased mucosal enhancement, likely reflecting sequela of chemotherapy.