71-year-old female with history of upper tract urothelial cancer status post surgery and chemotherapy PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Status post cystectomy with a right lower quadrant ileal conduit. There is a horseshoe shaped enhancing mass in the cystectomy bed, surrounding the posterior left aspect of the urethra, measuring 2.6 x 2.3 x 3.4 cm (series 1001, image 46; series 401, image 35).LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral pars defects with grade 1 anterolisthesis of L5 on S1. Nonspecific enhancing, T1 and T2 hypointense foci in the posterior left iliac wing and anterior right iliac wing. Peripherally enhancing, T1 bright lesion in the left femoral diaphysis. OTHER: No significant abnormality noted.
1.Enhancing mass in the cystectomy bed as described above is consistent with local recurrence.2.Nonspecific osseous lesions in the posterior left iliac wing, anterior right iliac wing, and left femoral diaphysis raises the question of metastasis. A bone scan, or ideally a PET scan, is suggested for further evaluation.