Presentation
Abdominopelvic pain, chronic constipation, and rectorrhagia.
Patient Data
Asymmetrical marked increased wall thickness due to tumoral infiltration is present at the mid and distal thirds of the rectum that infiltrates the mesorectal fascia. The fat planes between the mass, cervix uteri and vaginal canal are preserved.
Multiple enlarged lymph nodes with a maximum SAD of 32 mm are noted in the perirectal regions. The left inguinal region has an enlarged lymph node with an SAD of 15 mm. Several enlarged lymph nodes with SAD less than 38 mm are evident in the para-aortic regions. Additionally, A few enlarged mediastinal and hilar lymph nodes are observed with a maximum SAD of 15 mm.
A 15 mm cyst is noted in the right liver lobe.
Several subpleural and intraparenchymal nodules in both lungs, less than 10 mm, inferring metastases.
Degenerative changes, including osteophytosis, are seen in the thoracolumbar spine. There is also scoliosis with leftward convexity and partial collapse at T10, T12, L3 and L5 vertebral bodies.
Case Discussion
Pathology-proven rectal adenocarcinoma with mesorectal fascia involvement, regional, paraaortic, mediastinal and hilar lymphadenopathy and pulmonary metastases.
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