58-year-old female with diagnosis of anal cancer. A large perianal ulcer on left periaortic region consistent with recurrent anal cancer and firm and indurated left inguinal region highly suspicious for recurrent nodal involvement with cancer. PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Enhancing left inguinal lymph node measuring 3.3 x 3.3 x 5 cm (series 401 image 26, coronal series 501 image 8).BOWEL, MESENTERY: The anal tumor measures 1.9 x 1.4 cm and is located between the 3:00 and 5:00 position (series 701 image 21). The necrotic mass extends inferiorly from the anus to the left medial perineal soft tissues. Some tumor extends anteriorly along the skin to the level of the vagina. No intrapelvic involvement of the vagina is noted.BONES, SOFT TISSUES: Post radiation changes of the regional bones.OTHER: No significant abnormality noted.
Necrotic mass extends from the anus to the left medial peritoneal tissues with anterior extension along the skin to the level of the external vagina.