63-year-old woman with history of recurrent rectal cancer status post subtotal vaginectomy. PELVIS:UTERUS, ADNEXA: Patient is status post subtotal vaginectomy. There is circumferential, nodular thickening of the remaining vagina (901/29) with enhancement. Bilateral ovaries are seen.BLADDER: There is a Foley catheter within the bladder. There is diffuse, circumferential wall thickening of the bladder, nonspecific; however at the level of the base, heterogeneously enhancing soft tissue signal suspicious for neoplastic extension.LYMPH NODES: Multiple nodules within the presacral space and along the peritoneal reflections described below.BOWEL, MESENTERY: Patient is status post proctocolectomy with right lower quadrant abdomen ostomy. Within the presacral space, there is now confluent, near circumferential soft tissue thickening along the peritoneal reflections which enhances avidly. This enhancing soft tissue abuts the obturator internus musculature bilaterally (1101/265). Additionally, there are nodular soft tissue deposits in the presacral space (601/20) with at least one nodular focus seen abutting the right obturator internus muscle as well. For reference, a presacral nodule measures 11 x 8 mm. The majority of these lesions are solid, however there is a mixed cystic/solid deposit immediately anterior to the sacrum (901/46), newly appearing from earlier exam.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Vaginal wall thickening and nodular, irregular enhancing soft tissue in the surgical cavity suspicious for locally advanced recurrent disease with possible involvement of bladder (specifically base), please refer to details above.