50-year-old female status post hysterectomy, concern for recurrent endometrial carcinoma status post surgery 11/16/2015 who presents for characterization of pelvic fluid collection.Additional history obtained from gynecology service, Dr. Libbe Hassenfritz, patient with hysterectomy in 2009 for endometrial carcinoma. Patient presented in October with concern of recurrent endometrial carcinoma. Patient with rectosigmoid resection with creation of Hartmann's pouch, mucocutaneous fistula; transverse loop colostomy on 11/16/2015. PELVIS:UTERUS, ADNEXA: Status post hysterectomy and bilateral salpingo-oophorectomy.BLADDER: No significant abnormality noted.LYMPH NODES: There are mildly prominent pelvic lymph nodes.BOWEL, MESENTERY: Postoperative changes of rectosigmoid resection with creation of Hartmann's pouch, mucocutaneous fistula; transverse loop colostomy.BONES, SOFT TISSUES: There is a complex appearing T1 hypointense and T2 heterogeneous collection in the left hemipelvis measuring approximately 7.1 x 3.1 cm. This collection demonstrates peripheral rim diffusion restriction. There is contrast enhancement of the peripheral rim as well as peripheral nodularity within the collection (series 1002, image 362). This complex collection/lesion is adjacent to the anastomosis. When compared across modalities, this fluid collection was present on the previous examinations.There is ill-defined soft tissue around the ostomy site and anterior abdominal wall with areas of enhancement, likely representing inflammatory changes.Additionally, there is a ventral abdominal wound with packing material, unchanged.OTHER: There is mild enhancement of the synovium of bilateral hip joints which is likely reactive versus synovitis.
1.Complex left hemipelvis collection as above concerning for necrotic tumor, postcontrast enhancement seen both peripherally and within structure.2.Inflammatory changes in the anterior abdominal wall near the ostomy again noted.3.Mild enhancement of bilateral hip joints may be reactive in etiology versus synovitis.