Urothelial cancer with known right ischial metastasis There is a destructive lesion with questionable nondisplaced pathologic fracture centered within the right ischium. The lesion measures 5 x 2.5 cm in the transverse dimension and 6.5 cm in the craniocaudal dimension. The mass penetrates the cortex in multiple areas and there is mild edema and enhancement of the adjacent soft tissues. Edema and enhancement extends anteriorly to partially involve the inferior pubic ramus which may reflect marrow extension of tumor. Several small rounded foci of abnormal signal intensity and enhancement are noted within the ischium just superior to the main lesion, likely representing additional areas of disease. There are no additional abnormal foci or enhancement within the bones of the pelvis.The hamstring origin appears intact. Severe degenerative disc disease affects L5-S1. There is a tiny rim enhancing elongated fluid collection lateral to the left iliotibial band which may be the result of prior trauma or intervention but is not necessarily of any current clinical significance.Again seen is an enlarged residual distal ureter on the right containing both fluid and intermediate signal intensity. This is of uncertain etiology or significance but the possibility of residual malignancy is not excluded; however this correlates to similar findings on comparison CT exams. An elongated right iliac lymph node is also noted comparable to that seen on prior CT as well. There is prostatomegaly.
Destructive right ischial lesion with other findings described above.