42-year-old female with locally recurrent cervical cancer undergoing external beam radiation with brachytherapy. Routine monitoring during treatment with MRI. PELVIS:UTERUS, ADNEXA: Large nearly circumferential cervical mass is redemonstrated, extending to the mid to low uterine body. It measures approximately 6.5 x 5.3 x 7.0 cm (AP by ML by CC dimensions), previously 6.7 x 5.0 x 8.5 cm. Invasion into the vagina, parametrium and posterior bladder is again seen, with large fistulous communication between the bladder and vagina/uterine cavity redemonstrated (series 901, image 28). Total tumor volume appears to have slightly decreased in size, as evidenced by aforementioned measurements and extent of tumor into the uterine body. Tumor is again noted abutting the rectum posteriorly without definite evidence of invasion.BLADDER: Invasion of the posterior bladder by cervical mass, as described above. Bilateral nephroureteral stents are again noted.LYMPH NODES: Multiple pathologically enlarged bilateral inguinal pelvic lymph nodes are redemonstrated. A right pelvic lymph node measures 1.8 x 0.9 cm (series 1301, image 223), previously 2.8 x 1.9 cm. Other pelvic and inguinal lymph nodes are also stable to mildly decreased in size.BOWEL, MESENTERY: New rectal wall thickening likely represents radiation-related effects.BONES, SOFT TISSUES: The partially imaged anterior L5 vertebral body lesion demonstrating hypointense T1 and T2 signal and rim peripheral enhancement on postcontrast images is suspicious for osseous metastasis and is more prominent than seen on prior imaging.OTHER: No significant abnormality noted.
1.Large cervical mass has slightly decreased in size. Invasion and fistulization with the posterior bladder is redemonstrated.2.Lymphadenopathy is stable to slightly decreased, as above.3.Increased size of a peripherally enhancing L5 anterior vertebral body lesion, suspicious for metastasis though may also represent radiation-related effects.