MRI
Evidence of total abdominal hysterectomy with bilateral salpingo-oophorectomy.
There is a 40 x 42 x 50 mm abnormal signal solid-enhancing infiltrative necrotic mass lesion with water restriction on DWI images at the site of surgical resection just above the vaginal cuff that shows invasion to :
parametrium
vaginal cuff
serosal surface and muscular layer of urinary bladder posterior wall
mesorectal fascia and the serosal surface of the rectum
There are also two abnormal signal enhancing lymph nodes with water restriction with maximum SAD of 9 mm and 5 mm next to the left and right external iliac chains, respectively could be due to metastasis.