Reason: history of NF1 and malignant peripheral nerve sheath tumor of the right pelvis/groin; concern for increasing soft tissue nodule in post-op bed in R groin; please evaluate History: R groin pain Again seen are postsurgical changes of a left lower extremity amputation with hip disarticulation. There is associated marked fatty muscle atrophy of the left hip musculature, appearing similar to the prior study. Again seen are innumerable cutaneous lesions the multiple masses within the pelvis compatible with neurofibromas. Sacral dural ectasia and scalloping of the posterior aspect of the vertebral bodies appear similar to prior. The reference right inguinal lesion has been resected, previously measuring 4.6 x 3.7 x 7.3 cm. This is increased signal abnormality on fluid sensitive sequences within the surrounding soft tissue and subcutaneous fat which enhances on postcontrast sequences and likely represents postsurgical changes/granulation tissue. However, some of this signal abnormality has a more nodular appearance (image 20; series 301). Close attention on follow-up examination is recommended to evaluate for interval change and to exclude the possibility of residual or recurrent disease.The reference left psoas muscle lesion measures 4.3 x 4.1 cm, previously 4.2 x 4.0 cm (series 301; image 34).The reference left posterior pelvic lesion measures 4.0 x 4.0 cm, previously 3.9 x 4.1 cm (series 301; image 19).The reference of tissue mass in the fundus of the uterus has been resected, previously measuring 7.6 x 5.8 cm. The patient is status post hysterectomy.
Interval resection of the reference right inguinal and uterine masses consistent with the patient's known history of malignant peripheral nerve sheath tumor as well as uterine fibroids. There is enhancing signal abnormality in the right inguinal region which presumably represents postsurgical scarring/granulation tissue. However, some of this signal abnormality has a more nodular appearance and follow-up examination is recommended to exclude the possibility of residual or recurrent disease.