Postby Mattie » Sun May 24, 2020 11:16 am
Hi all, JUST SO HAPPY With these results!!!!
CT SCAN OF THE CHEST, ABDOMEN AND PELVIS with IV contrast 5/14/2020
9:10 AM
HISTORY: Colon cancer, follow-up
TECHNIQUE: CT examination of the chest, abdomen, and pelvis was
performed following the intravenous administration of 125 mL
Isovue-370. Sagittal, coronal and 3-D reformatted images were
provided. CT dose lowering techniques were used, to include:
automated exposure control, adjustment for patient size, and or use of
iterative reconstruction.
COMPARISON: December 23, 2019
FINDINGS:
Chest:
Pulmonary Parenchyma and Airways: 3 mm nodule peripheral left lower
lobe (series 5 image 201), unchanged. No new pulmonary nodule. Lungs
otherwise clear. The trachea and airways are normal.
Pleural and Pericardial Spaces: No pleural or pericardial effusion.
No obvious pleural or pericardial mass.
Mediastinum and Hila: Simple cyst adjacent to the right atrium (series
2 image 63) measures 1.8 x 4.2 cm, unchanged; Hounsfield density is 6,
consistent with water density. This is consistent with a benign
pericardial cyst, stable..
Chest wall and axilla: No mass or adenopathy.
Cardiovascular: No evidence of aortic aneurysm or aortic dissection.
The heart size is normal. The pulmonary artery is normal in size.
Abdomen:
Liver: 5 mm hypodensity right lobe of liver (series 2 image 99), 2
small to characterize but unchanged. Unchanged resection posterior
right lobe with no recurrent lesion. No new liver lesion. No
intrahepatic or extrahepatic biliary ductal dilatation.
Gallbladder: Numerous small dependent gallstones unchanged. No
gallbladder inflammation.
Pancreas: Normal. No ductal dilatation.
Spleen: Normal.
Kidneys: No hydronephrosis, mass, or stone.
Adrenals: Normal.
Stomach and Small Bowel: No bowel wall thickening or dilatation.
Appendix, Colon, and Rectum: Appendectomy. Rectosigmoid anastomosis
intact. Previously appreciated wall thickening at the anastomosis is
no longer present.
Peritoneum/Mesentery: Unremarkable.
Retroperitoneum: No mass or adenopathy.
Abdominal Wall: Left periumbilical hernia contains a single loop of
nondilated small bowel, unchanged.
IVC and Aorta: No aneurysm.
Ascites: None.
Free Air: None .
Pelvis:
Urinary Bladder: Normal.
Reproductive Organs: Hysterectomy. No adnexal mass.
Nodes: No adenopathy.
Bones: No fracture or aggressive osseous lesion.
IMPRESSION:
1. Stable exam. There is no evidence of metastatic or recurrent
disease.
4/10 debulk surgery, DX stage IVb, 49yo
5/10-11/11 Folfox, then Xeloda/Avastin
4/13 Resect liver met + pelvic node, 20+ Rad treatments
7/14 SBRT 15 mm Liver & node
12/14 SBRT 8 mm Liver met
3/16 4-5 pelvic nodes, Xeloda/Avastin again
12/16 NED, maintaining Xeloda/Avastin
8/17 NED Dropping Xeloda. Avastin only.
3/21 NED Avastin only
10/21 Pausing Avastin Proteinuria/BP complications
12/21 Resect 4.4 x 3.6 cm lower abdominal met