6 weeks post-resection of the pelvic mass and hysterectomy-BSO, the mass measures 11.2 x 13.4 x 19 cm, corresponding to size progression. Development of multiple confluent rim-enhancing nodules centered on the surgical bed surrounding the vaginal cuff and abutting the posterior urinary bladder wall. Interval extension into the bilateral ischioanal fossae, involvement of the right piriformis muscle, and presence of permeative changes in the right lower sacrum.
Development of small bowel obstruction with a transition point at the mid ileal loops surrounded by the pelvic mass.
New peritoneal nodules in the right lower quadrant.
New nodules in the prevesical space, laparotomy scar, and subcutaneous tissue of the right abdominal wall.
Worsening pelvic lymphadenopathy.
New bilateral lung nodules, suspicious for metastatic disease (not shown).