There is a large irregular ill-defined mass lesion centred on the colonic wall of the hepatic flexure in the right upper quadrant measuring 10 x 8.5 x 7 cm in maximum dimensions with surrounding fat stranding. Medially, the mass is in contact with, and is possibly adherent to, loops of non-distended small bowel.
There is para-aortic lymphadenopathy measuring 15 mm in maximal short axis diameter consistent with nodal metastatic disease. There is freefluid in the upper abdomen around the liver and spleen in the pelvis with no freeintraperitoneal gas.
The liver contains no focal lesions. The portal and hepatic veins are opacified. The gall bladder is contracted. The pancreas, spleen, and right adrenal gland are normal.There is an abnormal irregular soft tissue density in the left upper quadrants that appears to communicate with the left adrenal gland and may represent adrenal or nodal metastatic disease. There are cortical cysts in both kidneys measuring up to 35 mm inmaximum diameter.
There is abnormal soft tissue density in the right retroperitoneum inferior to the kidney measuring 19 mm maximal diameter. It may represent nodal or distant metastatic disease. There are bilateral inguinal herniae containing fat, larger on the left. Mild distal colonic diverticulosis noted. No distended loops of bowel to suggest obstruction. There is slight superior endplate deformities in the lumbar spine probably due degenerative change. No destructive skeletal lesion is detected.
A number of subcutaneous deposits are also noted.