66-year-old female with papillary serous endometrial cancer status post TAH/BSO now with pelvic mass, assess disease extent. PELVIS:UTERUS, ADNEXA: There are postsurgical changes of hysterectomy and oophorectomy. At the vaginal cuff, there is a soft tissue mass measuring 7.0 x 3.6 cm in the transverse dimension (801/27) and 2.0 cm in the craniocaudal dimension. This mass is ill-defined with multiple satellite nodules and extension into the peritoneum with small peritoneal implants, reflecting carcinomatosis. Some of these implants are removed from the soft tissue mass (601/64). There is extension throughout the parametrial fat with implants close to but not immediately associated with the sidewall (601/45). Tumor is present along the peritoneal reflection of the bladder. The mass also abuts the anterior aspect of the rectum (601/47). There is enhancing tissue along the anterior surgical scar which also likely represents tumor.BLADDER: See above.LYMPH NODES: There is inguinal lymphadenopathy with enlarged left inguinal node measuring 2.3 x 1.7 cm (601/31). There are multiple enlarged pelvic lymph nodes with an enlarged right common iliac node measuring 2.1 x 1.4 cm (601/57).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is a large amount of abdominal ascites.
1.Infiltrative soft tissue mass at the vaginal cuff with extension into the parametrial soft tissues and peritoneum as well as abutment of the bladder and rectum. Consider upper abdominal imaging by CT.2.Multiple peritoneal implants with a large amount of abdominal ascites.3.Pelvic and inguinal lymphadenopathy.