71 year old female with a history of chordoma. Evaluate for progression. Again seen is a lobulated hyperintense lesion centered at the S3 level, measuring approximately 6.0 cm in the transverse dimension, 2.5 cm in AP dimension, and approximately 4.5 cm in the craniocaudal dimension. It is difficult to determine whether or not this mass has increased very slightly in size compared to the prior study due to slight positional differences between the examinations. Again seen is extension of the mass into the anterior presacral soft tissues. There is minimal enhancement of the lesion that appears predominantly peripheral in nature.Again seen is a small nodule posterior to the left sacroiliac joint that now measures approximately 2.0 cm in its greatest dimension, which appears to have increased in size when compared to the prior study, although it shows no enhancement following contrast administration.Edema and fluid extending along the posterior inferior right sacrum appears similar to the prior study, which may be postoperative in etiology.The reference subcutaneous lobular mass posterior to the right paraspinal musculature measures approximately 3.2 cm in the greatest dimension which perhaps has increased slightly in size when compared to the prior study, showing little, if any, enhancement following gadolinium administration.There is mild diffuse heterogeneity of the bone marrow which appears similar to the prior study and is of doubtful clinical significance. There is fatty atrophy of the gluteal musculature, right greater than left, appearing similar to the prior study. Note is made of decreased signal abnormality within the uterus consistent with fibroid. Severe degenerative disc disease affects the imaged lower lumbar spine.
Sacral chordoma with satellite soft tissue lesions which have perhaps increased slightly in size when compared to the prior study.