61 year-old female. Recurrent urothelial cancer, pelvic pain, evaluate for progression. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Expected mild hydronephrosis with diversion into a right lower quadrant ileal conduit.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical findings in the small bowel and colon from partial resection. Anterior mesenteric soft tissue nodule, likely a metastasis (series 11, image 30).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Postsurgical findings of total vaginectomy. BLADDER: Postsurgical findings of cystectomy and right lower quadrant ileal conduit.LYMPH NODES: Left inguinal lymphadenopathy and soft tissue nodules in the left lower abdominal wall, likely metastaticBOWEL, MESENTERY: Postsurgical findings in the small bowel and colon from partial resection.BONES, SOFT TISSUES: 5 x 4.8 cm soft tissue mass in the central lower pelvis within the operative bed invading into the right labia consistent with residual tumor. Multiple soft tissue nodules inside the pelvis, studding a small bowel loop and sigmoid colon consistent with local metastasis. Additional multiple soft tissue nodule metastases are seen in the medial proximal pelvic musculature (obturator internus, obturator externus, pectineus) and in the perineum, including one on the left that is 2 x 2.1 cm. Comparison to prior is difficult given presence of extensive background post-surgical changes. Post-surgical findings of bilateral superior pubic rami resection and edema in the pelvic muscles.OTHER: No significant abnormality noted.
Significant residual tumor in the operative bed in the central lower pelvis with multiple soft tissue metastatic nodules in the perineum and medial pelvic musculature.