History of esophageal cancer status post CRT. New, small but significantly hypermetabolic right iliac is focus is very suspicious for progression of a solitary intramuscular metastasis seen on PET. There is a small mass, measuring less than 1.5 cm in greatest dimension, situated between the deep fibers of the right iliacus muscle and the underlying iliac wing. It is isointense to skeletal muscle on T1-weighted images, hyperintense to skeletal muscle on fat-suppressed T2-weighted images, and shows mild enhancement following gadolinium administration. This corresponds to the hypermetabolic focus seen on the recent PET CT scan and is compatible with a soft tissue metastasis. There is edema surrounding this mass between the iliacus and the iliac wing, but I see no signal abnormality within the right ilium itself. Bone marrow signal intensity is within normal limits. I see no additional soft tissue masses.
Small nodular mass within the right iliacus along the right iliac wing corresponding to the hypermetabolic focus on recent PET scan is compatible with a soft tissue metastasis from the patient's esophageal cancer.