Anastasia Zherlitsyna — timeline

National

Cancer Institute

Ministry of Health of Ukraine

National Cancer Institute

33/43 Lomonosova st, Kyiv, Ukraine, 03022

www.unci.org.ua, e-mail: info@unci.org.ua

MEDICAL DOCUMENTATION
Form of primary accounting documentation No. 028/0 APPROVED
Order of the Ministry of Health of Ukraine of February 14, 2012 No. 110

STUDY OF MAGNETIC RESONANCE TOMOGRAPHY

1. Surname, first name, patronymic of the patient: Zherlitsyna Anastasia Stanislavivna

2. Date of birth (DD/MM/YYYY): 25/04/1976

3. Medical card of an outpatient: 15766\22

4. Name of the diagnostic device:

5. Contrast agent: yes

Research protocol: MRI of abdominal organs, pelvic organs with intravenous contrast enhancement
Anamnes morbi : LeiomioSa uteri, gr IV, T2NxM1 (liver, sarcomatosis of the abdominal cavity, greater omentum), state in the process of combined treatment. Clinical group 2 (cancer patients who are prescribed anticancer treatment (surgery, radiation therapy or chemotherapy)).

MRI of abdominal organs:

The stomach is not full, the walls are not visually thickened.
The liver is significantly increased in size, measuring 209x240 mm (in MRI control from 08/24/2022 190x240mm) due to multiple formations in the liver parenchyma of a cystic-solid structure with tendency to fusion, the largest dimensions in the right lobe are 172x108mm. There is a focus in S8 of the liver mostly of solid structure 82x61mm (in MRI control from 08.24.22 – 77x51mm). There is a focus in the left lobe of the liver 75x57mm (in MRI control from 08.24.22 - 66x42mm).
In projection a. renalis sinistra there is a structureless tumor infiltrate 74x60 mm (53x58 mm in MRI control).

Loops of the intestine are adjacent to the infiltrate, without MRI signs of invasion at the time of examination.

The gallbladder has clear and even contours, the wall is not thickened, the contents are homogeneous.
The pancreas is structural, has a lobular structure according to age, the ductus arteriosus has a normal course and diameter of the lumen.
The right kidney is compressed, displaced caudally, the left kidney is placed typically, the corticomedullary differentiation of the kidneys has not changed, the contours are clear.
Adrenal glands without features.
The spleen has not changed, the contours are clear.

MRI of pelvic organs:

Uterus anteflexio \ anteversio.

The body of the uterus is asymmetrically enlarged in size to 113x101x95mm due to multiple myomatous nodes, the largest size in the projection of the back surface of the uterus is an intramural node of 28mm in diameter with signs of hyaline degeneration.

In addition, in the projection of the bottom of the uterine body, a rounded solid mass extending to the anterior abdominal wall, with heterogeneous internal contents, a structure with signs of cellular transformation, active collateral and internal blood flow was revealed. After the introduction of a paramagnet, active contrast enhancement of the node was detected. The outer contour is uneven, clear, the pseudocapsule is preserved. On the upper contour of the formation of a loop of the intestine, without convincing signs of invasion at the time of examination. On the right lateral contour, the infiltrate is adjacent to the iliac vessels, without convincing signs of invasion. The total maximum dimensions of the formation are 71x54x88mm (in the MRI control from 08/24/2022, 65x60x88, the formation changed its shape without changing its size). Parametric vessels are dilated and tortuous.

The uterine cavity is not expanded, up to 3 mm sagittally in total. The external contour of the body of the uterus is uneven and unclear.

Cervix is structural 26x25x24mm. Small nabothian cysts. The cervical canal is even and clear.

The left ovary is not enlarged, follicular impoverished. In the projection of the left ovary, there is a simple thin-walled cyst of 10x7 mm, with a homogeneous liquid content.
The right ovary is seen fragmentary, fibrotic, and follicular impoverished. In the projection of the ovary, cysts with liquid hemorrhagic contents are 51 mm in diameter (in MRI control from 08/24/2022 without significant dynamics).
Vagina is unchanged.
Traces of free fluid in the small pelvis. Swelling of adipose tissue of the small pelvis.
Lymph nodes in the small pelvis are not enlarged.
The bladder is compressed, moderately filled, the walls are fibrous, not thickened.
The urethra is not changed. The ureters are not dilated.

The sigmoid colon is closely adjacent to the formation, without convincing signs of invasion at the time of examination.

The rectum is not changed.

Bones: Focal bone destruction was not detected. Degenerative disc disease (DDD) of the lumbar spine, sacral spine.

7. CONCLUSION:

MRI signs may correspond to sarcomatous transformation of the myomatous node of the uterine body - in the MRI control from 8/24/2022 without significant dynamics. Multiple mts foci in the liver in MP control from 08/24/2022 - Prolongacio morbi. Tumor deposit in the retroperitoneal space on the left - in the MRI control from 08/24/2022, an increase in size. RECIST 1.1 PD.

14.10.2022 Radiologist O.M. Havrilyuk