Reason: 55 yo with anal cancer with recent resection of hepatic met (involving diaphragm). Known tumor in anal/rectal area with suspected invasion of pelvic sidewall. Evaluate current status of disease History: met anal cancer 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: 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 increased tumor involvement along the right aspect of the vagina. In the mid to distal vagina, there is an area of narrowing (26/21, 25/39) with proximal fluid within the upper vagina and cervix. BLADDER: No significant abnormality noted.LYMPH NODES: Hypermetabolic lymph node on prior PET/CT is not within the field-of-view of either the abdomen or pelvis images.BOWEL, MESENTERY: There is near circumferential bowel wall thickening involving the anterior, right lateral and posterior aspects of the rectum and anal canal measuring approximately 10 cm in length extending from the anal verge proximally. Circumferential thickening of the rectum is unchanged measuring approximately 1 cm (25/30) in thickness, however there is increased soft tissue nodules along the right anterolateral aspect of the rectum in the mesorectal fat. The largest of these nodules measures 3.1 x 2.8 cm (25/37), previously 2.2 x 2.5 cm. These nodules extend beyond the mesorectal fascia on the right into the right ischioanal fossa (25/41). There is increased extension along the right aspect of the vagina to nearly the right labia.BONES, SOFT TISSUES: Increased T2 signal throughout the musculature of the pelvis it is likely related to radiation changes. Radiation changes are also evident within the sacrum.OTHER: No significant abnormality noted.
1.Rectal mass has increased in size with increased invasion into the vagina.2.Fluid in the upper vagina and cervix is likely due to obstruction.3.Resection of hepatic dome lesion. No new hepatic lesions are evident.4.Hypermetabolic lymph node seen on prior PET/CT is not within the field-of-view of either the abdomen or pelvis images.