Locally advanced cervical cancer status post external beam radiation therapy. MRI for brachytherapy planning. PELVIS:UTERUS, ADNEXA: The uterus measures 6.8 x 3.8 cm in the sagittal plane. In the dorsal right posterior fundus there is a 3.1 x 2.3 cm well-defined T2 weighted hypointense subserosal fibroid.The endometrium/endometrial cavity is normal in thickness. The inner myometrium/junctional zone is poorly defined but is not thickened. Unremarkable bilateral ovaries appear atrophic without focal lesion.The vaginal canal is well distended by ultrasound gel. Intermediate T2-weighted signal hypointensity involves nearly the entire cervical thickness with signal abnormality extending towards the internal cervical os and lower uterine segment myometrium, measuring approximately 4.5 x 2.7 cm in maximal cross-section best seen on the postcontrast images (series 100 3/3 63). In the right parametrial soft tissues there is an enhancing lesion measuring 1.8 x 1.3 cm suspicious for parametrial soft tissue extension (series 100 3/3 88), adjacent to the non-enhancing ovary.Peripherally enhancing right obturator lesion measures 1.7 x 1.5 cm (series 100 3/4 13), suspicious for necrotic lymph node.BLADDER: No significant abnormality noted.LYMPH NODES: Peripherally enhancing right obturator lesion measures 1.7 x 1.5 cm (series 100 3/4 13), suspicious for necrotic lymph node.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Cervical mass with invasion into the lower uterine segment myometrium and right parametrial/paracervical soft tissues with a peripherally enhancing centrally necrotic right obturator lymph node. These findings correspond to FDG PET avid disease on the outside hospital PET/CT.