Patient with an acute hemoglobin drop and right lower extremity sarcoma. Please evaluate for hematoma.IMAGE ACQUISITIONS: CT of the right thigh without contrast enhancement; transverse, coronal, and sagittal views are provided CT of the right thigh without contrast enhancement again shows a large heterogeneous mass within the posterior thigh, which appears comparable to that seen on the MRI from June. Centrally, the mass is of prominently low density, which likely represents a combination of blood, fluid and/or necrosis. The periphery of the mass is isodense to muscle. Although the previous MRI showed findings consistent with internal hemorrhage, there are no specific findings on this exam showing new hemorrhage or hematoma. However, acute extravasation cannot be assessed in the absence of contrast enhancement. The right sacroiliac joint is fused as seen previously.
There is a large soft tissue sarcoma which is comparable in appearance to the previous MRI study. The heterogeneous appearance may be due to internal hemorrhage as seen on the previous MRI; however, the possibility of acute extravasation cannot be determined in the absence of contrast.