Reference is made to the prior scan.
As previously demonstrated, there is a large chordoma arising from the inferior aspect of the right sacral ala with inferolateral extension into the mesorectal fat, the ischiorectal fossa and the gluteus maximus muscle. There has been increase in extent and dimensions of the mass. Superiorly, there is increase in the component within the right posterolateral aspect of the mesorectal fat with obliteration of the fat plane between the mass and the rectum. There is no extension within the lumen of the rectum. There is increase in the component within piriformis muscle and also increase in the AP diameter of the gluteus maximus muscle invasive component.
There is interval small exophytic nodule extending from the mass in the right ischiorectal fat.
Prior sacral surgery and fat grafting in the sacral spinal canal are unchanged.
Conclusion: There is further increase in the size of the right sacral chordoma as detailed.