Case Records of the Massachusetts General Hospital: Case 29-1990

A repeated CT scan of the abdomen (Fig. 1 ) showed a soft-tissue mass, 5 by 5 by 3 cm, that filled the presacral space; the mass appeared lobulated over its anterior aspect; soft-tissue extension was observed around the rectum; a rounded soft-tissue mass, 5 cm, was projected superior to the uterus and indented the left side of the dome of the bladder; it was believed to be consistent with a leiomyoma; there was an incomplete fat plane between the presacral mass and the rectum. A radionuclide bone scan, performed after the intravenous injection of 99m Tc methylene diphosphonate, disclosed evidence of increased activity at the right anterior and left posterior mandibular areas, believed secondary to dental disease, as well as in the region of the sphenoid bone; increased activity was also seen in the midportion and lower portion of the sacrum.