74-year-old female with urethral cancer, preop planning. PELVIS:UTERUS, ADNEXA: The uterus is either atrophic or has been surgically removed.BLADDER: There is a Foley catheter in place and the urinary bladder is nondistended. There is trabeculation of the bladder wall which may reflect chronic outlet obstruction.LYMPH NODES: There is an enlarged right inguinal lymph node, most likely representing a metastatic deposit.BOWEL, MESENTERY: There is severe diverticulosis of the sigmoid colon and distal descending colon.BONES, SOFT TISSUES: There are degenerative changes of the lower lumbar spine resulting in spinal canal stenosis.OTHER: There is an ovoid mass within the urethra extending from the vesicourethral junction into the distal urethra, near the introitus. The mass demonstrates intermediate T2 signal and enhancement, compatible with reported history of urethral cancer. The Foley catheter traverses the mass. Ill-defined crescentic enhancement is noted posterior to the urethra extending towards the vagina (series 1009/142), suspicious for extraurethral extension. Associated punctate susceptibility artifact may reflect hemorrhage from prior biopsy. Diffusion-weighted imaging is limited by motion. Reference measurements below.INDEX LESION MEASUREMENTS (Current exam date/time: 10/7/2016 08:00:00)URETHRAL MASS: 2.8 x 2.6 cm (Image 140, Series 9).RIGHT INGUINAL LYMPH NODE: 2.1 x 1.9 cm (Image 145, Series 9).
1.Findings compatible with a urethral mass with possible posterior extraurethral extension.2.Enlarged right inguinal lymph node consistent with metastatic disease.