73-year-old female with recurrent mass. Assess for bladder involvement. PELVIS:UTERUS, ADNEXA: Status post hysterectomy. No adnexal masses.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Predominately cystic mass with peripheral nodular enhancing components, compatible with known metastatic carcinoma, is not significantly changed in size since prior CT on 5/22/2015 and again measures up to 5.6 x 5.3 cm (series 1 101/1 69). The bulk mass is centered below the left pelvic floor with mass effect upon and probable involvement of the atrophied left obturator externus, as well as anterior displacement of the left pectineus muscle in the left thigh. There is also mass effect on the left puborectalis muscle with mild extension into the left ischioanal fossa. A small portion of the mass protrudes superiorly through the obturator foramen into the pelvis. However, the fat plane is preserved between the mass and the bladder with no evidence of bladder invasion, as clinically questioned. There is tumor infiltration into the adjacent left pubic bone extending towards the symphysis with abnormal bony signal and enhancement seen (series 1101/185). Loss of bone about the posterior left acetabulum is most likely due to prior surgical changes with no abnormal enhancement seen. Chronic sacral fracture noted.OTHER: No significant abnormality noted.
Large predominantly cystic mass with the bulk centered just below the left pelvic floor, compatible with known metastatic carcinoma as detailed above. No evidence of bladder invasion, as clinically questioned.