Presentation
Weight loss and altered bowel habit. Colonoscopy in keeping with a rectosigmoid tumor.
Patient Data
CT CHEST
Multiple small nodules in both lungs measuring upto 9mm.
No significant mediastinal lymphadenopathy.
CT ABDOMEN
4.7cm segment of circumferentially thickening rectosigmoid, the serosa of which if irregular suggesting extra-serosal extension.
Irregular soft tissue in the sigmoid mesentery.
Multiple mesorectal nodes.
Para-aortic lymphadenopathy, several with high attenuation within, upto 2.7cm
Several liver metastases the largest 3.5cm in segment 6.
Case Discussion
The CT appearances are typical of an advanced metastatic colorectal maligancy.
The liver, lungs and infra-diaphragmatic nodes are the commonest sites of metastasis.
The high attenuation within the nodes, as on this case, is typical of mucinous adenocarcinomas.
This was a biopsy proven mucinous adenocarcinoma of the colon.
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