Ewing sarcoma, restaging Note that the evaluation of the femur is severely limited secondary to the presence of a femoral endoprosthesis and hip arthroplasty.Again noted are surgical changes in the lateral soft tissues of the right upper thigh with a linear tract extending from the skin to the the vastus lateral and intermedius. There is persistent low signal intensity on T1 and bright signal on T2 although the extent of T2 hyperintensity within the musculature appears slightly improved from the prior exam (series 13 image 7/44 compared to series of 11 image 35/52 on the prior). There is persistent heterogeneous enhancement of the left thigh without discrete mass. There is fullness of the lateral thigh (image 13/44 of series 21) which appears to be related to muscular outpouching, conceivably related to scarring, however continued attention in this area is recommended on future exams. There is generalized mild fatty atrophy of the thigh musculature which is similar to the prior exam.
Significantly limited examination secondary to susceptibility artifact. Within the limits of the exam, there is no discrete mass identified. There is persistent heterogeneous enhancement of the lateral thigh musculature with an area of fullness in the lateral thigh which may be related to scarring and tethering of the musculature however attention to this area on follow-up exams is recommended.