ke/sb/nl/rg.
Name of the Patient : Abc Xyza Palmn / M / 61 yrs.
Referred by : Dr. Abc Xyzrivastav.
Examination : M.R.I. of the Pelvis.
CLINICAL PROFILE :
C/O backache and pain in the LLE.
EXAMINATION :
M.R.I of the pelvis was performed using the following parameters:
8 mm thick T1 Weighted and T2 Weighted (with fat saturation)
axial images.
5 mm thick T1 Weighted and STIR coronal images.
6 mm thick T2 Weighted sagittal images (with fat saturation).
OBSERVATION :
There is destruction of the left acetabulum. A large, mixed signal intensity mass lesion is seen within the pelvis and involving the left iliac wing. This lesion is seen to turn heterogeneously hyperintense on the T2 Weighted and STIR images. Few areas within this lesion are hypointense on the T1 Weighted images and turns hyperintense on the T2 Weighted images and would represent cystic/necrotic changes. Subtle hyperintense areas within this lesion on the T1 Weighted images are seen to turn hypointense on the T2 Weighted images and would represent altered blood. There is displacement and probable involvement of the left ilio-psoas muscle and the gluteus muscle. Medially, this lesion is seen to extend into the pelvic cavity causing compression and displacement of the urinary bladder to the right. The superior pubic ramus and ischium are also involved by the pathology on the left. The left femoral head shows a focal hyperintense signal, anteriorly. A minimal left hip joint effusion is noted.
Hyperintense signal is seen deep to the right gluteus maximus
muscle which may be due to intramuscular injection.
..2/.
There are no abnormally enlarged pelvic lymph nodes identified. No obvious vascular anomaly is noted. There is no free fluid in the pelvis.
Focal hyperintense signal on the T2 Weighted and STIR images is noted in the right iliac bone, posteriorly (scans 106.2).
IMPRESSION :
The MRI features are suggestive of a mass lesion arising from the left iliac wing, involving the left superior pubic ramus and ischial bone with extensions as described. The possibilities to be considered are :
1. Chondrosarcoma.
2. Round cell tumor.
3. Metastasis.
Focal altered signal in the right iliac bone is of ? etiology, ?? metastasis from the left iliac lesion.