58-year-old male with recurrent urothelial carcinoma and pelvic abscess. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild intrahepatic biliary dilatation and mild dilatation of the common bile duct is stable. Ill-defined hypodensities in the left lobe of the liver, best seen on image number 30, series number 3 is unchanged.SPLEEN: No significant abnormality notedPANCREAS: Small cystic lesion in the tail of the pancreas is unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index left para-aortic node is unchanged, measuring 13 by 8mm image number 63, series number 3. And, more caudal index node is also unchanged, measuring 13 by 12-mm in width. Number 76, series number 3.BOWEL, MESENTERY: Also in the right and left lower quadrants. No evidence of bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy. Previously measured complex fluid collection containing air in drainage catheter and fistulizing into the skin is slightly increased, now measures 7.8 x 5.9 cm image number 121, series number 3. There is tissue defect in the midline pelvis.BLADDER: Ileal pouch is noted.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Ill-defined enhancing lesion in the lower midline pelvis measuring 4.9 x 2.8 cm is suspicious for recurrent tumor. MRI may helpful for better characterization of this mass separate from the collection. The mass invades the base of the penis and abuts the pelvic bones.
Interval increase in the size of the complex pelvic fluid collection. Retroperitoneal lymph nodes are stable.Possible pelvic mass, suspicious for recurrent disease. MRI of the pelvis may be helpful for better characterization of this lesion, if clinically indicated.