History of anorectal squamous cell carcinoma. ABDOMEN:LIVER, BILIARY TRACT: T2 hyperintense restricting lesion in the right hepatic dome demonstrating peripheral enhancement and mild internal enhancement measures 3.7 x 3.1 cm (series 1501/48), compared to 1.8 x 1.6 cm previously (series 12001/5). No new lesion. No biliary ductal dilatation or vascular abnormality. Normally distended gallbladder.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: See discussion below. Right adnexal T1 weighted hyperintense and T2 weighted hypointense 2.5 x 1.9 cm lesion without macroscopic fat likely represents an endometrioma, unchanged. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Between the right superior aspect of the vaginal cuff and the rectum there is a bilobed lesion measuring 3.4 x 2.4 cm (series 2 302/58) demonstrating peripheral thick walled enhancement, restricted diffusion and mild internal enhancement, significantly decreased in size from the prior outside MRI. There is mild tethering versus communication with the lateral aspect of the rectum. The adjacent lower rectum demonstrates circumferential wall thickening and hyperenhancement. A soft tissue component extends posterolaterally towards the right into the presacral space (series 2 302/72). Dorsally there is a 1.5 x 1.0 cm enhancing nodule which appears to be centered in the distal sacrum/coccyx (series 2 302/78).BONES, SOFT TISSUES: There is feathery T2 weighted hyperintensity of the lower pelvic musculature and mild enhancement without a discrete mass lesion, favoring myositis. No focal lesion corresponding to the FDG avid foci seen on PET/CT 10/24/16. OTHER: No significant abnormality noted.
1.Increasing size of the right hepatic dome lesion. No new liver lesion or other site of metastatic disease.2.The low rectal/anorectal mass is markedly decreased in size from the 6/18/2015 MRI with a residual bilobed centrally necrotic component in the rectouterine space. The disease is grossly similar to the PET/CT findings accounting for technical differences. 3.Right adnexal 2.5 cm lesion, unchanged from 06/18/2015, favor endometrioma given stability. 