CLINICAL INDICATION: 73-year-old male with right adrenal adenoma for follow up.
COMPARISON: 6/13/13. Correlation with CT 3/20/14.
FINDINGS:
Multiple transverse and longitudinal sonograms were obtained through the abdomen.
The liver is normal in size. The hepatic parenchyma is mildly heterogeneous. The capsular surface of the liver is smooth. A 3.5 cm lobular cyst is present within the lateral left lobe. A 2.7 cm septated cyst is identified within the inferior medial left lobe. The cysts are slightly larger compared to the prior CT.
The spleen is poorly visualized due to shadowing from overlying bowel gas.
The gallbladder and visualized pancreas are unremarkable. The pancreatic tail is partially obscured by shadowing from overlying bowel gas. There is no bilary ductal dilation. The extrahepatic bile duct measures 3.4 cm.
The smoothly marginated ovoid mass in the right suprarenal region is keeping with the known adrenal gland mass currently measures 1.9 x 1.8 x 2.0 cm. stable from the previous CT. The mass is slightly larger compared to the 6/18/12 CT.
The right and left kidneys measure 10.7 and 10.5 cm respectively in length. The renal parenchyma is of normal thickness and echogenicity. No hydronephrosis, renal calculi or perinephric fluid collection is seen.
The visualized descending abdominal aorta is of normal caliber. Main portal vein diameter at the porta hepatis is 13 mm. Limited Doppler analysis demonstrates patency of the main portal vein with hepatopetal flow.
No free intraperitoneal fluid is seen.
IMPRESSION:
1. Stable right adrenal gland mass, slightly larger compared to the 6/18/12 CT, likely an adenoma. Additional evaluation would include MRI or continued limited ultrasound follow up.