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CT Abd Obturator Schwannoma

Findings: Soft tissue density posterior to the right nipple is consistent with mild gynecomastia. Calcifications are noted in the aorta, coronary arteries and aortic valve. Lung bases are clear.

Punctate calcification in the spleen is consistent with a granuloma. Mild enhancement of the gallbladder wall is noted without gallbladder wall thickening or gallstone. This is of doubtful significance. The liver, spleen, pancreas and adrenal glands are unremarkable. Lobulated appearance of the kidneys is noted bilaterally without focal mass lesion or hydronephrosis.

Numerous diverticula are noted throughout the descending colon. There is no adjacent fat stranding to suggest diverticulitis at this time. The appendix fills with contrast. There is no free fluid in the abdomen. There is no evidence of small bowel obstruction. The prostate is mildly prominent without focal mass lesion identified.

There is an ovoid, nonenhancing lesion in the left pelvis which extends through the obturator foramen and follows the expected course of the obturator nerve. This measures approximately 2.5 x 2.2 x 5.6 cm in diameter and is of uncertain etiology but suspicious for a lesion such as an obturator nerve schwannoma. Left-sided obturator externus atrophy is also identified. Correlate with physical exam findings. MRI of the pelvis can be performed for further evaluation as deemed clinically appropriate.

Diffuse degenerative changes are noted throughout the spine with moderate to severe facet hypertrophy at the L4-L5 and L5-S1 level. Variable canal and foraminal stenosis is noted, most severe at the L4-L5 level there is moderate canal and foraminal stenosis.

1. Diverticulosis without evidence of diverticulitis. There is no evidence of bowel obstruction or other findings to suggest acute intra-abdominal pathology.
2. Ovoid hypodense lesion following the expected course of the left obturator nerve through the obturator foramen with associated left obturator externus atrophy. This is of uncertain etiology. Findings could represent a primary neurogenic tumor such as a obturator nerve schwannoma or neurofibroma. Correlate with physical exam. Pelvic MRI can be performed as deemed clinically appropriate.
3. Other findings as above.