Pelvic exenteration: role of CT in follow-up

Fifty-five computed tomography (CT) scans of the pelves and abdomens of 33 patients who had undergone pelvic exenteration were reviewed. There were 27 gynecologic and six colorectal malignancies. The interval between surgery and the first CT scan ranged from 2 weeks to 37 months (median, 8 months). CT findings included abnormal fluid collections (33.3%), abnormalities of the neovagina (30.3%) and presacral soft tissues (36.4%), increased hydronephrosis (54.5%), and lymphocysts (6.1%). Tumors recurred in 17 of 33 patients (51.5%) at a median interval of 9 months after surgery and had several CT manifestations. The most common of these was a soft-tissue mass of variable density and shape, but pelvic fluid collections as well as abnormalities of the neovagina and presacral soft-tissue layer were also associated with tumor recurrence. The surgical indications, methods, and potential post-operative complications of pelvic exenteration were reviewed and the role of CT in the follow-up of these patients was emphasized.