77-year-old male with sacral mass and known metastases.Additional clinical history from service includes left-sided buttock pain. There is a mass occupying the majority of the right half of the S2 vertebra with focal extension across the sacroiliac joint. It measures about 5.2 x 4.2 x 4.5 cm, similar to prior study. Although the size of the mass appears similar to the prior study, there is now only peripheral enhancement following IV contrast, indicating treatment effect. The mass contacts the right S1, S2, and S3 neuroforamina, appearing similar to prior study. There are multiple, small enhancing foci within the bones of the pelvis bilaterally, likely representing metastatic disease. For reference purposes, a lesion in the anterior left iliac wing measures approximately 1.2 cm in greatest transverse dimension and corresponds to area of increased uptake on prior PET scan. We also see small focus within the right sacral wing.There is mild edema within the left sacral wing with a poorly defined linear low signal component anteriorly which may represent a stress fracture.Osteoarthritis affects the right greater than left hips. Degenerative disc disease affects the lumbar spine, most severely at the L4-L5 level.Incidentally noted left bladder diverticulum.
1.Right-sided sacral mass with multiple small metastatic foci within the bones of the pelvis bilaterally.2.Edema within the left sacral wing associated with a linear low signal component anteriorly suggestive of a developing stress fracture.3.Osteoarthritis and other findings as above.These findings were discussed with Joyce Tang at 11:20 AM on 7/29/2016 by telephone.