Female 46 years old with mass in uterus, cystic on CT, solid on ultrasound and a new diagnosis of choriocarcinoma. PELVIS:UTERUS, ADNEXA: There is a 6.0 x 5.8 cm x 9.0 mass within the anterior right lateral myometrium (series 501, image 28 and series 701, image 17). The mass has peripheral T1 hyperintensity and heterogeneous T2 hyperintensity centrally indicating complex content. There is some rim enhancement but no internal enhancement. The adnexa appear normal.BLADDER: No significant abnormality noted.LYMPH NODES: There are multiple enlarged lymph nodes along both pelvic sidewalls. For reference, a left pelvic sidewall lymph node measures 12 x 9 mm (series 1004, image 379).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Enhancing lesions are seen in the bilateral iliac bones and sacrum. The largest is in the right sacrum and measures 13 x 8 mm (series 1004, image 519).OTHER: There is a moderate amount of pelvic free fluid.
1.Large uterine lesion for which the differential includes choriocarcinoma and degenerating fibroid. 2.Bilateral pelvic lymphadenopathy is concerning to metastatic disease.3.Enhancing lesions in the sacrum and iliac bones may represent metastases. Correlate with bone scan as clinically warranted.