History of uterus fibroids. Evaluation for embolization. PELVIS:UTERUS, ADNEXA: The uterus is markedly enlarged due to multiple fibroids including intramural and subserosal fibroids. It measures 11.4 x 11.2 cm in the sagittal plane.The dominant subserosal fibroid in the left uterine body/fundus measures 8.7 x 7.9 cm, compared to 9.2 x 8.5 cm previously. The right fundal subserosal exophytic fibroid measures 5.5 x 4.8 cm. These demonstrate avid postcontrast enhancement.Demonstrated again is a T1 hyperintense T2 hypointense right adnexal lesion measuring 2.8 x 2.4 cm (series 4/19), compared to 2.8 x 2.2 cm previously, compatible with an endometrioma. Similar lesion in the left adnexa measures approximately 1.8 x 1.0 cm.Normal endometrial thickness. Several punctate T2 cystic foci in the inner myometrium/junctional zone compatible with adenomyosis.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is a T2 hyperintense enhancing lesion in the S1 vertebral body measuring 2.6 x 2.6 cm (series 4/34) suspicious for a metastatic lesion given the history of carcinoid.OTHER: No significant abnormality noted.
1.2.6 cm enhancing S1 vertebral body lesion suspicious for metastatic disease especially given the history of carcinoid. Further staging imaging is recommended to evaluate for other sites of metastatic disease.2.Enlarged myomatous uterus containing avidly enhancing fibroids. 3.Adenomyosis. 