Presentation
Rectal cancer for staging.
Patient Data
Tumor: annular
Distance from anal verge 90 mm
Extends craniocaudally 65 mm
Distal edge lies at 50 mm above puborectalis sling
Upper border lies at 25 mm above the peritoneal reflection
Staging:
Tumor edge: from 1 o'clock to 3 o'clock
Muscularis propria: extends through
Extramural spread: 10 mm at 3 o'clock
EMVI: present
Adjacent to the extramural venous invasion, there is a 17 x 14 mm solid lesion with an irregular border in the presacral region, invading the adjacent CRM, likely to represent a tumor deposit,
Peritoneal reflection: not involved
Adjacent pelvic organs (lev ani, prostate, vagina): not involved
Conclusion: T3c CRM involved EMVI pos N1 mid rectal tumor
Case Discussion
Staging MRI showing features consistent with T3c mid rectal tumor, N1, CRM involved, and EMVI positive with tumor deposits.
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