Multiple myeloma restaging.
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Left hilar soft tissue without obstruction. Bilateral retroperitoneal/perirenal masses. Presacral and extraperitoneal pelvic/space of Retzius masses. Subcutaneous and muscular (right paraspinal) masses. Multiple bone lesions.
When staging/restaging multiple myeloma, keep a look for soft tissue masses (plasmacytomas), realizing that they can affect all organ systems. Expand your search pattern to carefully look for muscular and subcutaneous sites of disease, which might be targeted for palliative radiation therapy.