The appendix is dilated and thick walled, with surrounding stranding in keeping with acute appendicitis. Moderate surrounding inflammatory change, with no extraluminal gas or collection.
At the base of the appendix in the caecum, there is a hyperdense mass. Pericaecal fat stranding is also demonstrated. Enlarged ileocaecal lymph nodes are present.
In the right liver there is a hypodense lesion.
Conclusion:
Suspected caecal cancer obstructing the appendiceal orifice, with acute appendicitis. Right liver hypodense lesion in this context is suspicious for a metastasis. MRI liver is suggested for further evaluation and to identify any other metastases.