There is a distal sigmoid mass lesion about 5 x 4.5 cm noted about 13.5 cm from the puborectalis sling (dentate line) and about 18 cm above the anal verge. It extenda beyond the muscularis propria. There is no line of cleavage between the sigmoid tumour and the posterior wall of the urinary bladder and hence if confirmed invasion, it could be staged as T4 b. There is enlarged large left mesorectal malignant mass lesion about 4 x 3.6 cm. There are small right pelvic sidewall as well as left external iliac lymph nodes.
There is peri-colic linear infiltration, suggestive of extramural vascular invasion (EMVI).
The prostate appears enlarged with lobulated outline as well as heterogeneous parenchyma.
Heterogeneous appearance of the bones is noted with no otherwise overtly destructive bony lesions.
No pelvic collection.
In summary, the MRI confirms a T4 status with bladder invasion.