A large ( 89 x 110 x 79 mm ) soft tissue mass replaces most of the superior right scapula with a pathological fracture through the base of the acromium and a further fracture through the body of the scapula. Mass extends to the margin of the glenohumeral joint but not into it.There is no involvement of the adjacent ribs or right humeral head. The mass does not encase the adjacent axillary artery or vein.
Surgical staples along the right side of the neck and an absent right sternocleidomastoid in keeping with the history of previous oropharyngeal cancer.
A 59 x 66 x 95 mm hypodense lesion in segment VI of the liver has multiple small satellite nodules and there is stranding in the surrounding fat. There is a linear hypodensity extending from the lesion to the posterior division of the right portal vein that is suspicious for thrombus in the segmental portal vein. There are multiple enlarged porta hepatis lymph nodes measuring up to 17 x 26 mm.
Multiple calcified gallstones are noted. The spleen, pancreas, kidneys and adrenals are unremarkable. The prostate is enlarged ( 59 x 47 x 30 mm ). There is moderate atheroma in the abdominal aorta.
Large right scapula destructive lesion with an associated soft tissue mass. In this setting the lesion likely represents a metastatic deposit. Possible further lesion in the right ilium.
Large liver lesion with surrounding satellite lesions and possible portal segmental vein thrombosis and associated lymphadenopathy.