PATIENT: snoopy wentink
HISTORY: previously diagnosed with peripheally invasive left adrenal mass 1.2cm diameter via PAV into CVC
There is considerable progression of disease here. The adrenal mass is larger in size being 1.4cm and the vascular invasion is much more extensive with a 3cm length of CVC now affected, and distortion / widening of CVC. Additionally there is a mass lesion in the trigone of the urinary bladder which is likely to reflect TCC and catheter aspiration or surgical biopsy of this would be required for definitive diagnosis.
BILIARY TRACT: Normal
LEFT KIDNEY: Normal
RIGHT KIDNEY: Normal
LEFT ADRENAL: Abnormal: 1.4cm diameter, prominent and hypoechoic with internal hyperchoic speckling. Invasion via the phrenoicoabdominal vein which is dilated and solid / hypoechoic into cVC which is distended cranially with solid hypoechoic contents causing defect on colour doppler evaluation.
RIGHT ADRENAL: 8mm diameter, hypoechoic / prominent
URINARY BLADDER: Abnormal: solid hyperechoic irregularly marginated lesion 0.5 x 0.9cm diameter in trigone region with internal hyperechoic speckling and extending into proximal urethra
ILIOSACRAL LYMPH NODES: Normal
VISCERAL LYMPH NODES: Normal
SMALL INTESTINES: Normal
LARGE INTESTINES: Normal
GENITAL TRACT: Not applicable