This is a transcription of the radiologist's analysis of the pelvic and abdominal CT scans taken on 5/30/07. =================================== CT ABDOMEN W/CONTRAST REASON: PELVIC MASS PROCEDURE: [omitted here] COMPARISON: None. FINDINGS: An ovoid complex mass arises from the lower pole of the right kidney, with a mildly shaggy and moderately microlobulated margin. The mass shows central low attenuation and a peripheral enhancing soft tissue attenuation rim of up to 1.5 cm thickness. The dimensions of this mass are 97 x 72 x 68 mm. There are prominent vessels in the adjacent perinephric fat surrounding the lower pole of the right kidney and there is mild asymmetric thickening of the renal and lateral conal fascia. An additional 5 mm low attenuation focus is seen in the anterior lower pole of the right kidney, not accurately characterized due to small size but probably representing a small cyst. Remaining portions of the right kidney and the left kidney are unremarkable. Appropriate excretion of contrast material. Enhancement of the right renal vein is not optimally assessed due to relatively poor overall contrast enhancement on the portal venous phase images but there is no definite evidence for tumor thrombus. Small, non-enlarged lymph nodes are seen adjacent to the aorta and right renal hilum. Liver, spleen, adrenal glands, pancreas, and gallbladder are unremarkable. No significant GI tract pathology. The appendix is visualized and normal. No abnormal lymphadenopathy or definite abnormal fluid collection. Small hiatal hernia. Lung bases show no significant abnormality. No significant skeletal pathology. IMPRESSION: 1. 9.7 cm greatest diameter, complex, probably centrally necrotic right lower pole exophytic renal mass, consistent with renal cell carcinoma until proven otherwise. 2. No definite evidence of metastatic disease in the abdomen. 3. Prominent right perinephric vessels and asymmetric thickening of the renal and lateral conal fascia which may be due to vascular engorgement. Metastatic involvement cannt be entirely excluded. 4. No other significant abnormality on biphasic CT of the abdomen. =================================== CT PELVIC W/CONTRAST REASON: PELVIC MASS PROCEDURE: [omitted here] COMPARISON: None. Correlation with prior pelvic ultrasound, 17 May 2007. FINDINGS: The uterus is moderately to markedly enlarged as reported on the prior ultrasound. The uterus extends cephalad to the level of the umbilicus and the fundus is deviated to the left. It measures 20.8 x 9.4 mm in greatest dimensions on sagittal images and up to 10.3 cm transversely. In the uterine body and lower uterine segment is bulbous and bulky in configuration. Additional smaller areas of crescentic low attenuation are seen in the fundal region. No definite focal mass. Ovaries are not reliably visualized, probably compressed and displaced. A low attenuation structure up to 2 cm in diameter to the left of the uterine fundus may represent part of the left adnexal, not reliably characterized, particularly due to lack of oral contrast enhancement. Aside from peripheral displacement in the pelviz due to the enlarged uterus, the GI tract seen in the pelvis is unremarkable. No significant pelvic lymphadenopathy or definite abnormal fluid collection. Mildly prominent vessels, not unusual accounting for the enlarged uterus. No significant skeletal pathology. IMPRESSION: 1. Enlarged heterogeneous uterus, mot likely due to extensive myomatous change. An infiltrative mass cannot be reliably excluded by CT. Further information may be gained by MRI of the pelvis, if indicated. ===================================