40 year-old male with history of colon cancer, status post resection. Liver metastases, jaundice. CHEST:LUNGS AND PLEURA: Interval development of bilateral numerous parenchymal metastases. Previously mentioned right middle lobe nodule now measures 2.9 x 2.1-cm image number 51/106.MEDIASTINUM AND HILA: Subcarinal adenopathy measuring 1.6 by 1.3-cm image number 46/226.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple metastatic lesions in the liver. Large lesion in the right lobe measures 8.5 x 5.6 cm image number 90/226. Significant intrahepatic biliary dilatation. Common bile duct is completely decompressed. The level of obstruction is at the Klatskin point by an opacity hepatic lesion, and/or adenopathy.Main portal vein and left portal vein are patent. However right anterior and right posterior portal vein branches are diminutive and likely invaded by the ill-defined mass at the hepatic hilum.There are two percutaneous likely biliary drainage catheters in the right lobe. The intrahepatic biliary tree in the posterior segment of the right lobe is decompressed however biliary tree and anterior segment of the right lobe and left lobe are significantly dilated.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Paraceliac, hepatic hilar, left para-aortic adenopathy. There efferents note in the left para-aortic region measures 11 x 11 mm image number 137.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postoperative changes involving the rectum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
Interval progression of disease with increase in number and size of the lung metastases. New hepatic metastases and intrahepatic biliary dilatation as described above. Retroperitoneal adenopathy.