32 year old male with history of Ewing sarcoma off therapy. Assess for recurrence. Again seen is a well circumscribed mass within the retrovesicular space, not significantly changed in size, measuring 6.2 x 5.5 cm previously 6.1 x 5.6 cm. This mass again demonstrates heterogeneous high T1 and T2 signal with a hypointense rim likely reflecting blood products of varying ages. Following gadolinium administration, there is no enhancement. Mass effect on the adjacent rectosigmoid is also similar to prior.Amorphous curvilinear signal abnormality involving the left sacral wing and along the SI joint are similar to prior and may represent insufficiency fracture, post therapy changes or metastasis. Round focus of low signal with no enhancement in the posterior aspect of the left iliac wing may represent a treated metastasis and also appears similar to prior.No new foci of abnormal signal or enhancement.Wall thickening of the bladder and rectosigmoid may be related to radiation.
1.Unchanged pelvic mass.2.Foci of signal abnormality within the pelvic bones appear similar to prior and may represent a combination of treated metastases and post radiation changes. 3.No new foci of abnormal signal.