History of anal cancer on chemotherapy with history of resection of hepatic metastasis involving the diaphragm, please restage and compare to previous. ABDOMEN:LIVER, BILIARY TRACT: Status post resection of hepatic dome lesion seen on the prior study. No new hepatic lesions are evident. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate T2 hyperintensities in the right kidney are too small to characterize but likely represent small cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: T1 hyperintense lesion is unchanged, likely an endometrioma.There is circumferential wall thickening and increased enhancement involving the vagina with a soft tissue mass along the right posterolateral aspect of the lower vagina and along the right anterolateral aspect of the rectum as described below. The fluid within the upper vagina and cervix has decreased.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is near circumferential bowel wall thickening and increased enhancement involving the anterior, right lateral and posterior aspects of the rectum and anal canal measuring approximately 12 cm in length extending from the anal verge proximally. Circumferential thickening of the rectum has slightly increased now measuring up to 1.2 cm in thickness (series 3, image 29). Soft tissue masses along the right aspect of the rectum in the mesorectal fat and along the right pelvic sidewall have increased in size; for example the previously described soft tissue mass along the right anterolateral of the rectum in continuity with vagina measures 3.6 x 2.7 cm (series 3, image 20), previously 3.1 x 2.8 cm. These masses extend beyond the mesorectal fascia on the right into the ischioanal fossa (series 3, image 15). BONES, SOFT TISSUES: Heterogeneously decreased T1 signal within the bone marrow as well as increased T2 signal within the musculature of the pelvis may be related to radiation changes.OTHER: No significant abnormality noted.
1.Interval increase in size of pelvic masses involving the rectum and vagina as well as the right pelvic sidewall and ischioanal fossa.2.Surgical changes related to resection of hepatic dome lesion. No new hepatic lesions identified.