CT of the chest and abdomen with IV contrast — second reading (RNI Neu-Isenburg, Germany) — English translation

Source: "Zherlitsyna - Zweitbefundung перевод.pdf" (Russian translation of the German report, Drive root and docs_eng/UKR_orig), signed PD Dr. med. A. Maataoui, RNI private radiology clinic, Neu-Isenburg; received December 2022. Translated from the Russian version on 11.09.2026.

Clinical data: uterine leiomyosarcoma, known hepatic and peritoneal metastases. Question: current status.

Chest

Correct perfusion of the supra-aortic and mediastinal vessels and of the cardiac chambers. Thin pericardial effusion, more on the right, up to 0.9 cm, density 0–10 HU (serous). No pathological thoracic lymph nodes, no mediastinal or hilar soft-tissue masses. Chest wall and breast parenchyma without focal lesions. Small subpleural bullae over the lung apices, single intraparenchymal bullae / differential centrilobular emphysema (smoking history?). No pulmonary foci suspicious for malignancy. A short segment of wall thickening along the right-lateral circumference of the trachea about 8.5 cm proximal to the carina, up to 0.6 cm craniocaudally and 0.3 cm deep, smoothly contoured and hypodense — a small mural tracheal lipoma. Thoracic skeleton without signs of malignant infiltration.

Abdomen

Liver with a large tumour burden from predominantly confluent metastases in both lobes; in the right lobe the metastases reach an axial diameter of 19 × 12 cm and a craniocaudal extent of 17 cm. At the hepatic hilum incipient compression of the common hepatic duct with secondary intrahepatic cholestasis in both lobes. Perfusion of the unaffected parenchyma is normal. Along the ventrobasal circumference of the right lobe (segment 4) incipient exophytic growth of the metastases. Spleen and adrenals not enlarged. Pancreas homogeneously perfused, no dilation of the pancreatic duct. Caudal to the pancreatic tail and dorsal to the stomach an inhomogeneously perfused mass up to 5.2 cm transverse and 6.1 cm craniocaudal. Kidneys with normal cortico-medullary enhancement, ureters not dilated. Bladder unremarkable.

Pelvis: two masses — immediately dorso-apical to the uterus, with suspected continuity, morphologically a subserosal myoma, up to 6 cm axial and 5 cm craniocaudal; and an inhomogeneously perfused mass at the ventral level of the pelvis up to 8.5 cm axial and 10 cm craniocaudal. Rectosigmoid and remaining colon without wall thickening. Single reactive para-aortic lymph nodes at the level of the renal hilum, otherwise no pathological abdominal lymph nodes. No significant ascites. Axial skeleton without malignant infiltration.

Conclusion (epicrisis)

Primarily hepatic metastatic disease with criteria of high dynamics at a large tumour volume with diffusely confluent foci; incipient exophytic growth along the ventrobasal circumference of the right lobe and incipient compression of the bile ducts with early intrahepatic cholestasis. Equivalently perfused masses caudal to the pancreatic tail and in the lesser pelvis with an inhomogeneous perfusion pattern, differential diagnosis peritoneal metastases. Additionally a smoothly contoured mass in the lesser pelvis, more likely a subserosal uterine myoma. No pulmonary metastases, no pathological thoracic lymph nodes. Thin serous pericardial effusion — clinical correlation advised. A benign tracheal mass in the middle third (differential lipoma). No malignant infiltration of the axial skeleton.