History of liposarcoma. Evaluate sciatic nerve in size of the mass. PELVIS:UTERUS, ADNEXA: Displaced towards the left by the large right hemipelvis mass. Otherwise unremarkable.BLADDER: Displaced towards the left by the large right hemipelvis mass. Otherwise unremarkable.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Demonstrated again is the heterogeneous enhancing mass in the right hemipelvis measuring up to 11.5 x 7.8 cm (series 9/25) in maximal cross-section. The lesion has fat and solid enhancing components. In the craniocaudal dimension the lesion measures up to 13.7 cm (series 11/21). The mass displaces the pelvic organs to the left specifically the bladder, uterus and the mesorectal fascia. The fat planes between the mass and the right piriformis muscle, uterus and bladder are indistinct which may represent tumoral involvement.The mass partially encases the right common and external iliac artery and vein. The lesion engulfs the right internal iliac artery and vein and its branches. The lesion has a component extending through the sacrosciatic notch to the level of the ischial tuberosity and encases the sciatic nerve to this level as well as the more proximal sacral nerve roots. The tumor extends tracks along the sacral plexus to the level of the right L5 and S1 neuroforamen. The lesion abuts the right sacral ala without discrete osseous invasion. OTHER: No significant abnormality noted.
1.Right pelvic liposarcoma with extensive mass effect and soft tissue involvement as described.2.The lesion engulfs the sciatic nerve to the level of the ischial tuberosity and tracks along the sacral plexus to the L5 and S1 right neural foramen. 