Reason: Endometrial cancer compare to last MRI and measure 1) vaginal cuff mass, 2) left inguinal node and 3) r. common iliac node History: post SBRT and 4 cycles of immunotherapy PELVIS:UTERUS, ADNEXA: Status post TAH/BSO.At the vaginal cuff, a previously seen soft tissue mass measuring 4.6 x 8.0 cm (601:46) now measures 4.6 x 8.0 cm (1301:38). Again, the mass is ill-defined with numerous satellite nodules and peritoneal extension with additional peritoneal implants with reflecting carcinomatosis. There is extension throughout the parametrial fat with implants close to but not immediately associated with the sidewall (601/45). Tumor is present along the peritoneal reflection of the bladder. The mass also abuts the rectosigmoid colon (1301:39). There is enhancing tissue along the anterior surgical scar which also likely represents tumor.BLADDER: See above.LYMPH NODES: Previously enlarged left inguinal node measuring 2.3 x 1.7 cm (601/31) now measures 0.5 x 0.9 cm (1301:23). There are multiple enlarged pelvic lymph nodes with an enlarged right common iliac node measuring 2.1 x 1.4 cm (601/57), now measuring 1.2 x 1.0 cm (1301:48).BOWEL, MESENTERY: Large volume ascites causing dielectric artifact limiting evaluation. This ascites has layering low intensity on T2 images (1301:29) suggesting some proteinaceous/hemorrhagic component. BONES, SOFT TISSUES: Mild anasarca.OTHER: There is a large amount of abdominal ascites.
1.Grossly stable infiltrative soft tissue mass at the vaginal cuff with extension into the parametrial soft tissue, along the peritoneum, and with abutment of both the bladder and rectosigmoid colon. Measurements above. Grossly stable numerous peritoneal implants and extensive ascites.2. Interval decrease in size of reference lymph nodes as described above.