A midline multilobulated cystic pelvic floor mass centred within the fibres/layers of the levator ani. It has a T1 intermediate signal, T2 high signal, no fat saturation and post contrast enhancement. Diffusion restriction is present in several locules.
The mass compresses and displaces the rectum and vagina superoanteriorly and the mid rectum laterally to the right. Inferiorly it pushes into the intersphincteric plane of the posterior aspect of the anal canal where it directly abuts the anal canal and lower rectum. Laterally and inferiorly on the left it appears to breach the pelvic floor to extend into the ischioanal fossa. It does not clearly directly involve the rectum although it may be attached to its posterior wall. No thick wall or nodular enhancement seen.
Both ovaries are normal and seen separately. No enlarged lymph nodes. No bone lesion or evidence of spinal communication. No free fluid.