Colorectal carcinoma

Case contributed by Frank Gaillard

Presentation

Abdominal pain and distention.

Patient Data

Age: 80 years
Gender: Male

AXR

x-ray

Abdominal x-ray demonstrates a distended colon with an apparent transition point in the left iliac fossa.

ct

 There is a 50mm, partially obstructing, circumferentially thickened, segment of large bowel at the level of the distal sigmoid colon. There is a surrounding mesenteric fat stranding with a 12mm left paraaortic node identified.

There are multiple nonenhancing low densities throughout the liver ranging in size from 8 mm to 24 mm. The gallbladder is absent. The CBD measures 7 mm.

Multiple high density foci in the the prostate represent either benign prostatic calcification or less likely brachytherapy seeds.

The a large pelvic calcification which lies immediately medial to the left vesicoureteric junction and may reside in a ureterocoele or bladder diverticulum.  The left ureter is not dilated.  A nonobstructing inferior pole renal calculus measuring 9 mm is identified. The kidneys, pancreas and spleen are otherwise unremarkable.

No free intra-abdominal fluid. No focal lung nodules visualized in the lower chest.

Extensive degenerative change throughout the lumbar spine and pelvis.  Incidental small right hiatal hernia.


Case Discussion

Typical appearances of a stenosing colorectal carcinoma.

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