Reason: h/o whipple surgery, 2015. Had f/u CT scan on last year. New find of subtle enhancing lesion of the right gluteal minimis measuring 1x1x4. Please evaluate History: none There is a small mass within the right gluteus minimus muscle measuring 1.6 x 1.3 x 4.0 cm (AP x TR x CC). It is slightly hyperintense to skeletal muscle on T1-weighted images and hyperintense to skeletal muscle on T2-weighted images and demonstrates uniform enhancement following contrast administration. Superiorly, there appear to be streaky foci of high signal intensity within the lesion that we suspect represent peripheral and septal fat overgrowth that may be seen with venous malformation ("intramuscular hemangioma"). Subjectively, the size of the mass appears similar to that of the CT examination from 4/7/16 and we are not convinced of interval growth. We see no additional soft tissue masses. There is a small amount of fluid within the right iliopsoas bursa. The bone marrow signal intensity is within normal limits. There is a small round focus of signal heterogeneity in the right ilium adjacent to the right sacroiliac joint which may represent a degenerative cyst. Degenerative disc disease affects the lower lumbar spine. Mild osteoarthritis affects the hips and pubic symphysis. Note is made of a fat-containing left inguinal hernia.
Small mass in the right gluteus minimus muscle as described above. The mass has some characteristics that are suggestive of a venous malformation/intramuscular hemangioma, however, if previous outside CT examinations or MRI examinations are available, we would recommend obtaining those scans for comparison. If prior examinations are not available for comparison, and interval change cannot be excluded, then referral to orthopedic oncology and possible subsequent biopsy may be considered.