CT
Axial C+ portal venous phase
Coronal C+ portal venous phase
Sagittal C+ portal venous phase
Multilobulated, multiseptated, 29 x 42 x 59 mm pelvic mass. Centrally the cystic areas demonstrate a density of approximately 30 HU.
Septated components are enhancing. No calcification.
Epicentre of the lesion lies just anterior to the sacral vertebral bodies, with subtle scalloping of L5 – S3.
Posteriorly, anterior to S3, the posterior border of the mass is less conspicuous. No definite foraminal widening demonstrated.
Caudally, the mass extends down through the rectovesicular recess, inferior to the level of the pubic symphysis just deep to the perineum, without evidence of infiltration through it. Mass displaces the rectum to the left side without obstructing it.
Anterior to the mass lies the collapsed urinary bladder.
Superiorly the mass extends to an S1 level. Mass effect upon the bilateral ureters is causing bilateral, upstream hydroureter and hydronephrosis. Normal renal cortical thickness and enhancement demonstrated bilaterally.