Female 58 years old with urethral cancer receiving chemoradiation. Evaluate for extent of disease; brachytherapy radiation planning. PELVIS:UTERUS, ADNEXA: Status post hysterectomy and bilateral salpingo-oophorectomy.Again seen is thickening and irregular, intermediate T2 signal in the anterolateral left vaginal wall and involving the posterior urethra. This is further described below. BLADDER: Large saddle urethral diverticulum is unchanged. Again seen within this diverticulum is a 25 x 17 x 26 mm T2 intermediate enhancing mass (series 501, image 27 and series 601, image 43) extending into the bladder base, previously 25 x 17 x 24 mm. Heterogeneity and enhancement of the adjacent pelvic floor and surrounding fat indicates local invasion similar to the previous exam. The mass abuts the urogenital diaphragm on the left. LYMPH NODES: 12 x 9 mm left pelvic wall lymph node with mild enhancement is suspicious for metastatic disease (series 501, image 49 and series 401, image 35).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: 11 x 7 mm cystic structure anterior to the femoral neck likely represents a para labral cyst, unchanged.
1.Stable size and appearance of locally infiltrative soft tissue mass extending along the posteriolateral left urethra to the anterolateral left vaginal wall consistent with the patient's known urethral cancer.2.Prominent left pelvic wall lymph node is suspicious for metastatic disease.3.Stable large saddle urethral diverticulum.