Cervical cancer. Evaluate for extent of disease prior to brachytherapy. PELVIS:UTERUS, ADNEXA: There is a tandem and ovoid device in place within the vagina and uterus. Marked interval decrease in size of patient's known cervical mass. In total axial dimension it now measures 7.1 x 4.2 cm (series 1103 image 473), previously 8.5 x 6.6 cm. Enhancement is now more heterogeneous with central areas of nonenhancement suggesting necrosis. The tumor is circumferential but the bulk of the disease is posterior to the cervix. There is involvement of the vagina.Uterus is normal in size. The ovaries are unremarkable and contain small follicles bilaterally.BLADDER: A Foley catheter is in the bladder which is collapsed limiting evaluation.LYMPH NODES: Borderline enlarged right external iliac lymph node measuring 10 x 6 mm has loss of the normal reniform contour suggesting nodal metastases (series 401 image 60). This is not significantly changed from prior.BOWEL, MESENTERY: Small bore rectal tube. The rectosigmoid colon abuts the cervical mass and there is no clear residual fat plane between the 2 structures (series 601 image 39, series 401 image 58). This suggests tumor invasion appears somewhat prior. No obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Marked interval decrease in size of cervical mass with measurements as described. Findings suspicious for tumor invasion into the adjacent rectosigmoid colon.2.Stable borderline enlarged right external iliac lymph node suspicious for metastasis.