CLINICAL DATA:  Metastatic endometrial cancer, assess treatment
response

EXAM:
CT CHEST, ABDOMEN AND PELVIS WITHOUT CONTRAST

TECHNIQUE:
Multidetector CT imaging of the chest, abdomen and pelvis was
performed following the standard protocol without IV contrast. Oral
enteric contrast was administered.

COMPARISON:  [DATE]

FINDINGS:
CT CHEST FINDINGS

Cardiovascular: Right chest port catheter. Scattered aortic
atherosclerosis. Left coronary artery calcifications. Normal heart
size. No pericardial effusion.

Mediastinum/Nodes: No enlarged mediastinal, hilar, or axillary lymph
nodes. Thyroid gland, trachea, and esophagus demonstrate no
significant findings.

Lungs/Pleura: Slight interval enlargement of multiple pulmonary
nodules, largest in the right lung base measuring 3.1 x 1.7 cm,
previously 2.3 x 1.5 cm when measured similarly (series 3, image
114). Interval enlargement of a flattened nodule of the inferior
right upper lobe abutting the minor fissure, measuring 1.0 x 0.9 cm,
previously 0.4 x 0.4 cm (series 2, image 33). Multiple additional
bilateral pulmonary nodules, are unchanged. No pleural effusion or
pneumothorax.

Musculoskeletal: No chest wall mass or suspicious bone lesions
identified.

CT ABDOMEN PELVIS FINDINGS

Hepatobiliary: Hepatic metastatic disease is poorly appreciated on
this examination, however there does appear to be at least 1 newly
enlarged lesion of the inferior right lobe of the liver, hepatic
segment VI, measuring 1.7 x 1.4 cm, previously no greater than 0.9 x
0.8 cm (series 2, image 76). No gallstones, gallbladder wall
thickening, or biliary dilatation.

Pancreas: Unremarkable. No pancreatic ductal dilatation or
surrounding inflammatory changes.

Spleen: Normal in size without significant abnormality.

Adrenals/Urinary Tract: Adrenal glands are unremarkable. Kidneys are
normal, without renal calculi, solid lesion, or hydronephrosis.
Bladder is unremarkable.

Stomach/Bowel: Stomach is within normal limits. Appendix appears
normal. No evidence of bowel wall thickening, distention, or
inflammatory changes.

Vascular/Lymphatic: Aortic atherosclerosis. Interval enlargement of
multiple retroperitoneal and aortocaval lymph nodes, largest left
retroperitoneal node measuring 2.4 x 1.7 cm, previously 2.0 x 1.2 cm
when measured similarly (series 2, image 72). Enlarged left iliac
lymph node seen on prior examination is however significantly
decreased in size, measuring 1.0 x 0.8 cm, previously 2.2 x 1.4 cm
(series 2, image 108). Interval enlargement of a peritoneal nodule
or right iliac lymph node in the vicinity of the right paracolic
gutter measuring 1.3 x 0.9 cm (series 2, image 106).

Reproductive: Status post hysterectomy.

Other: There are numerous new subcutaneous nodules about the low
abdomen, largest over the left lower quadrant measuring 3.9 x 1.9 cm
(series 2, image 107). Low midline ventral hernia containing
multiple loops of nonobstructed small bowel. No abdominopelvic
ascites.

Musculoskeletal: No acute or significant osseous findings.

IMPRESSION:
1. Slight interval enlargement of multiple pulmonary nodules, other
nodules unchanged.
2. Hepatic metastatic disease is poorly appreciated on this
examination, however there is at least one enlarged lesion.
3. Interval enlargement of multiple retroperitoneal and aortocaval
lymph nodes. Enlarged left iliac lymph node seen on prior
examination is however significantly decreased in size.
4. Interval enlargement of a peritoneal nodule or right iliac lymph
node in the vicinity of the right paracolic gutter.
5. Constellation of findings is consistent with mixed response to
treatment, however with significant overall evidence of worsened
metastatic disease.
6. There are numerous new subcutaneous nodules about the low
abdomen, likely injection granulomas, soft tissue metastases not
favored given appearance and distribution.

Aortic Atherosclerosis (0VXL1-ZVI.2).
