Comparison is made with the previous imaging done in November 08 and there has been debulking of the tumour. On the current imaging no tumour is seen anterior to the level of the sacrum. There is still extensive fairly well demarcated irregular whirled mixed signal tumour seen extending from the level of S2 to the coccyx. This also extends laterally to just below the level of the ischial spine in the ischiorectal fossae. There is no involvement of the rectum. The pararectal tissues demonstrate mild enhancement, which is probably postsurgical and post radiotherapy.
The lower lumbar spine and proximal sacrum are normal with normal exiting nerve roots and thecal sac.\
Multiple high T2 signal deposits are seen in the vertebral bodies the largest of which is at the level to T5 in a paravertebral location.
CONCLUSION:
Debulking has occurred surgically with no tumour now seen anterior to the anterior spinal line. The lateral/width extent is similar to that seen pre- surgically. The tumour is about 1/5th of its previous size. Most of the tumour is within the ischiorectal fossae bilaterally and within the S2 to S5 sacral elements. No rectal involvement.