Female; 81 years old. Reason: radiation planning for treatment of cervical cancer History: cervical cancer PELVIS:UTERUS, ADNEXA: Large cervical mass with intermediate T2 signal, restricted diffusion, and contrast enhancement measuring up to 3.4 x 5.3 x 4.6 cm (AP by transverse by craniocaudal, series 1403/468 and series 701/27), compatible with cervical cancer. The mass is predominantly confined within the uterine serosa. However, there is focal area of loss of fat plane between the mass and the rectum, suspicious for mild rectal invasion (series 601/36). There is also mild extension of the tumor beyond the serosa toward the left pelvic sidewall seen inferiorly (series 601/37). Lastly, there appears to be mild inferior extension to involve the left lateral aspect of the upper vagina, where mild increased vaginal wall thickening and enhancement is seen (series 1403/398).Low T2 signal material below the mass in the endocervical and vaginal canals with intervening high T1 signal, most compatible with packing material and blood products. Uterine fibroid at the fundus measuring up to 4.3 x 4.2 cm (series 1403/513). Additional smaller myometrial fibroids are seen in the uterine body bilaterally.BLADDER: Foley catheter tip in bladder.LYMPH NODES: Bilateral pelvic sidewall lymphadenopathy, compatible with metastatic disease. For future reference, the largest lymph node measures 1.7 x 2.6 cm in the right pelvic sidewall (series 1403/478). A smaller, rounded left pelvic sidewall lymph node is seen on series 1403, image 498.BOWEL, MESENTERY: See above.BONES, SOFT TISSUES: No suspicious osseous lesions.OTHER: Large left renal cyst extending into the superior pelvis, partially visualized.
1. Cervical cancer as detailed above with probable left pelvic sidewall and left upper vaginal involvement. Additionally, there is loss of the fat plane between the rectum, and underlying extension is not excluded, although not overtly seen.2. Bilateral pelvic sidewall metastatic lymphadenopathy, worse on the right.