History of recurrent ovarian cancer status post resection of upper abdominal mass. New pelvic mass on pelvic ultrasound. Pathology is high-grade poorly differentiated serous carcinoma. Recent splenectomy with metastatic disease. Left upper abdominal peritoneal implant. ABDOMEN:LIVER, BILIARY TRACT: Best seen on the postcontrast images is a 4 mm hypoattenuating lesion (series 30/81). This is associated with moderate T2 hyperintensity (series 9/25) and mild restricted diffusion (series 8/75). There may be a thin rim of enhancement. Although the lesion was present on the 10/27/2015 CT it was not present previously. There are nonspecific wedge-shaped regions of T2-weighted mild signal hyperintensity without associated focal lesion (series 9/23 and series 9 image 9). Additionally on postcontrast imaging there is a nonspecific tubular peripheral region of hypoenhancement in segment 7/8 of the liver without a discrete mass which may represent a segmental portal vein thrombus. No additional suspicious lesions. No biliary ductal dilatation. The vessels are patent.SPLEEN: Status post splenectomy.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted. KIDNEYS, URETERS: Left renal superior pole cyst.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal lymph nodes including left periaortic/peri-adrenal lymph nodes. These are not pathologically enlarged but are new from 2014 CT.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy and bilateral salpingo-oophorectomy. In the right surgical bed there is a 3.6 x 3.0 x 2.4 cm multilobular mass with internal hypo-enhancement and surrounding thick rind of soft tissue enhancement, compatible with recurrent/residual tumor. The margins of the tumor are poorly defined and the lesion abuts the adjacent rectosigmoid and vaginal cuff.BLADDER: No significant abnormality noted.LYMPH NODES: Hyperenhancing left external iliac lymph node measuring 0.9 cm in short axis (series 24/237).BOWEL, MESENTERY: Small volume of pelvic ascites with septations (series 18/31). There is mild enhancement of the involved peritoneal surface without a discrete nodular implant.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.3.6 cm multilobular mass in the right hemi-pelvis surgical bed is very suspicious for local recurrent tumor. 2.Small volume pelvic ascites with septations and mild peritoneal enhancement with a discrete nodular implant.3.Hyper-enhancing prominent left external iliac lymph node.4.Non-specific right hepatic lobe subcentimeter lesion is too small to definitively characterize, however is suspicious and attention to this lesion on subsequent imaging is recommended. Questionable subsegmental portal vein thrombus.5.Shotty retroperitoneal lymph nodes, slightly increased from 2014.