40 year-old female with HIV/AIDS and cervical cancer, status post radiotherapy. Presents with rectal bleeding. Evaluate for mass or inflammatory change. ABDOMEN:LUNG BASES: Small pleural-based nodules at the lung bases may be due to atelectasis or scar. No acute infiltrates or effusions.LIVER, BILIARY TRACT: Dilated gallbladder with cholelithiasis. Mild gallbladder wall thickening, possibly secondary to chronic cholecystitis. There is a benign hemangioma in the inferior right hepatic lobe, unchanged from the MRI examination.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is moderate left hydronephrosis and hydroureter with obstruction by infiltrative mass near the left ureterovesical junction, most likely a metastasis. The hydronephrosis is new since the MRI examination of 1/28/08.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse colorectal wall thickening, probably due to post-radiotherapy change. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: The uterus demonstrates heterogeneous contrast enhancement with loss of the normal fascial planes between the uterus and bladder most likely due to direct tumor invasion. The interface between the rectum and uterus/cervix is indistinct, probably due to post radiotherapy change. New 1 cm right sided intrauterine mass near the fundus at axial image 94/144 of series 3. BLADDER: Diffuse bladder wall thickening. Left sided 4 cm diameter intraluminal mass is stable since 1/28/08. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diffuse rectosigmoid wall thickening, probably due to post-radiotherapy change. BONES, SOFT TISSUES: Of sclerosis at the pubic symphysis is most likely due to radiation osteonecrosis.OTHER: No significant abnormality noted
Post-radiotherapy changes to pubic symphysis and rectosigmoid. Cervical mass invades bladder. New left hydronephrosis and hydroureter due to bladder mass and infiltrative changes at the UVJ. 