Colorectal cancer and a residual lesion in the left kidney

Case contributed by Melbourne Uni Radiology Masters


Anemia for investigation.

Patient Data

Age: 90 years
Gender: Female

Right hip rod/nail causes artefact, degrading diagnostic quality in the affected region. The study is also degraded by motion artefact.

There is a 1.5cm mass projecting into the bowel lumen at the rectosigmoid junction. There is also a stenotic lesion in the ascending colon. No bowel obstruction.

No liver lesion demonstrated. Cholelithiasis. There is a 5.3cm left upper pole exophytic renal or adrenal lesion with dense peripheral calcification. This has been present since the previous AXR and likely represents a calcified cyst or old hematoma. The left ovary is bulky for a patient of this age (2.6 x 3.0cm).

There are prominent para-aortic and bilateral iliac nodes, however these are not enlarged according to size criteria. Prominent vascular calcification. No free fluid.

No suspicious osseous lesion. Grade 1 retrosynthesis of L5 on S1 with degenerative changes.


Case Discussion

CT demonstrating stenotic lesion in the ascending colon and rectosigmoid nodule extending into the bowel lumen. Colonoscopy revealed a stenosing carcinoma and no lesion seen in the rectosigmoid region.

The calcified lesion in the upper pole of the left kidney or adrenal had remained unchanged since imaging 10 years prior.

It may represent calcification in a cyst or a calcified hematoma.

TB and hydatid are far less likely possibilities. 

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Case information

rID: 39180
Published: 25th Aug 2015
Last edited: 19th Aug 2020
Tag: rmh
Inclusion in quiz mode: Included

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