Presentation
Severe RIF pain.
Patient Data
Large pelvic mass that is heterogeneously enhancing peripherally with central fluid density and prominent calcifications. Left pelvic sidewall lymphadenopathy. There is a further calcific focus associated with the sigmoid colon.
Previous hysterectomy.
There is diffuse thickening of the sigmoid wall. There are some thick-walled loops of small bowel within the right lower quadrant anterior to the mass with mesenteric fat stranding.
Hepatic and renal cysts. Mild right hydronephrosis with the point of obstruction being the ureter as it passes between the right iliac vessels and the pelvic mass.
Case Discussion
This patient had a known history of Fallopian tube carcinosarcoma treated with hysterectomy and bilateral salpingo-oophorectomy. Despite best treatment, there is aggressive metastatic disease with the pelvic mass doubling in dimensions compared to a CT 8 weeks prior.
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