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CT Abd Fibroid

Findings: There is a large piriform midline pelvic mass that measures 16.0 x 11.3 x 14.6 cm that is interposed between the rectum and bladder and connects to the cervix inferiorly. There are a few peripheral and internal coarse calcifications. Minimal free fluid is present in the pelvis. The kidneys demonstrate a normal appearance. There are no urinary tract calculi. There is no hydronephrosis. No renal masses or cysts are evident. There is a round, lamellated stone in the gallbladder neck measuring 2.2 cm. The gallbladder wall is smooth and uniformly measures 3 mm. There is no pericholecystic fluid. There is no intrahepatic or extrahepatic biliary ductal dilatation. There is a hypodense lesion in the right liver dome measuring 1.7 cm. The bowel demonstrates normal course and caliber without wall thickening or obstruction. The spleen, pancreas, adrenals, and bladder are normal. There is bibasilar pleural thickening and plaque-like calcification in the right lower lobe. Mild degenerative changes are seen in the spine. Calcified right pleural plaque is noted, and may be consistent with asbestos related pleural disease. Minimal bilateral pleural thickening is likely reactive. Conclusion: 1. Large midline pelvic mass with coarse peripheral and internal calcifications. Given history of fibroids, this may represent progression of disease. However, given growth over time, recommend pelvic MRI to exclude uterine leiomyosarcoma. 2. Large lamellated gallstone without evidence of acute cholecystitis. 3. No urinary tract stone. Other incidental findings as above.