Case of the week 7

This week's case is an enhanced CT of the abdomen and pelvis in a 55 year old man with renal cell carcinoma status post left nephrectomy 6 months ago. He did not have metastatic disease on preoperative imaging.

The study was interpreted as "no evidence of recurrent or metastatic disease" by an abdominal-trained radiologist.

This case is an eye test. Remember the most common locations for missed metastatic disease.

What are the relevant findings?

What would be your diagnosis or differential?

Below are static images highlighting important findings

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