Reason: R shoulder soft tissue sarcoma, x/p chemo/xrt, evaluate for treatment effect prior to surgery History: above Note is made of a large heterogeneous mass abutting the posterior margin of the trapezius and superior margin of the supraspinatus, posterior to the scapular spine, measuring 8.0 x 6.1 x 5.4 cm, previously 6.3 x 4.8 x 4.8 cm, consistent with stated history of a soft tissue sarcoma. There are foci of internal increased signal abnormality on T1-weighted images likely representing blood products/internal hemorrhage. There are also fluid fluid levels identified internally. There is mass effect on the supraspinatus and trapezius musculature. There is also increased signal abnormality and fluid sensitive sequences within the medial aspect of the trapezius which demonstrates patchy enhancement on postcontrast sequences which is nonspecific but may reflect intramuscular extension of tumor, appearing similar to the prior study. No bone marrow signal abnormality is identified in the surrounding area. Note is made of heterogeneous bone marrow signal within the proximal humerus which may represent residual islands of red marrow. Although this examination was not protocoled for detailed evaluation of the rotator cuff musculature, there appears to be a partial-thickness bursal surface tear of the supraspinatus approximately 2.5 cm from the level of its insertion on the greater tuberosity. There is thickening and intermediate signal intensity within the supraspinatus indicating tendinosis. No evidence of lymphadenopathy.
Interval increase in size of the enhancing soft tissue lesion consistent with the stated history of soft tissue sarcoma with reference measurements and other findings as provided above.