Reason: Hx of NF-1, s/p excision of multiple MPNST, now with enlarging Right inguinal mass, evaluate for new MPNST History: above Stable postsurgical changes related to left lower extremity amputation and hip disarticulation with associated fatty muscle atrophy of the left hip musculature. Again seen are innumerable cutaneous lesions/masses within the pelvis, compatible with neurofibromas. Sacral dural ectasia and scalloping of the posterior aspect of the vertebral bodies also appears similar to prior. There has been interval increase in size of the masslike lesion in the region of the previously resected right inguinal neurofibroma, immediately anterior to the femoral vessels and abutting the medial psoas at the level of the acetabular dome. This lesion is isointense to skeletal muscle on T1 weighted images and hyperintense on T2, with heterogeneous enhancement, currently measuring 2.6 x 2.5 cm, previously 1.7 x 1.5 cm in transverse dimension. The adjacent poorly defined edema has decreased in size, which was likely in part post-surgical in nature.The reference left posterior pelvic lesion measures 4.4 x 3.9, previously 4.4 x 4.4 cm, not significantly changed when compared to prior. The remainder of the innumerable neurofibromas appear grossly similar to previous.
Innumerable lesions related to patient's neurofibromatosis. There has been slight interval increase in size of the right inguinal mass which is concerning for residual/recurrent malignant peripheral nerve sheath tumor, as detailed above.