Gastrointestinal stromal tumour: anorectal

Case contributed by Dr Nolan Walker

Presentation

Rectal pain

Patient Data

Age: 53
Gender: Male

MRI sequence

Modality: MRI

There is a thick-walled cavitating mass. There is central ulceration of the rectal mucosa overlying the tumour, and probable resultant secondary infection and necrosis accounting for the mixed density fluid within the tumoral cavity.

The seminal vesicles and prostate are displaced ventrally.


 

CT Chest, abdomen and pelvis

Modality: CT

There is a thick-walled enhancing mass centered on the lower rectum.  The mass is displacing the bladder anteriorly.  There are no enlarged pelvic lymphnodes and no suspicious liver or liver lesions.

Case Discussion

In the large bowel, GISTs are seen almost exclusively at the ano-rectal junction.

Importantly, GISTs very rarely metastasise to lymph nodes (<5 %) so the lack of localised lymph node enlargement for a tumour of this size, directs diagnosis away from rectal and prostate cancer.

Presented with Professor Marco Novelli MBChB MSc PhD FRCPath       

and

Dr Hameed Rafiee FRCR                                     

University College London Hospitals

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Case Information

rID: 47183
Case created: 3rd Aug 2016
Last edited: 20th Dec 2016
Inclusion in quiz mode: Included

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