19-year-old female patient with history of progressive pelvic desmoid tumor, currently being treated with tamoxifen. PELVIS: The ill-defined infiltrating mass in the left hemipelvis is mildly increased in size and currently measures 9.5 x 6.6 cm (series 8 image 43), previously 9.5 x 5.7 cm when measured similarly. The mass encases the left external iliac artery. The mass invades and occludes the left external iliac vein, with numerous collateral vessels identified. Anteriorly, the mass further invades and enlarges the left rectus muscle and adductor brevis. Laterally, the mass invades the left pelvic side wall, iliacus muscle, psoas muscle, and abuts the left acetabular cortex, similar to prior. Posteriorly, the mass extends into obturator internus muscle. Medially, the mass abuts left lateral bladder wall and adjacent loops of small intestine. The rectum appears uninvolved. UTERUS, ADNEXA: T1 and T2 hypointense probable pessary device in place in the vagina.BLADDER: The urinary bladder is displaced to the right.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mildly increased left thigh soft tissue edema, reflecting venous congestion of the aforementioned left external iliac vein occlusion.
1.Approximately 1 cm increase in size in the mediolateral plane with other dimensions and degree of invasion of pelvic musculature remaining stable.2.Persistent occlusion of the left iliac vein with venous collateral formation.