Rectal cancer

Case contributed by Andres Alberto Morales Cruz
Diagnosis certain

Presentation

The patient reported the onset of symptoms six months prior to the study, experiencing pain and intermittent bleeding during defecation. Subsequently, they developed chronic constipation.

Patient Data

Age: 75 years
Gender: Female

MRI pelvis

mri

Diffuse concentric rectal thickening at the level of the middle rectum at 7 cm from the anal verge, with a semicircumferential morphological pattern, lobulated edges, non-mucinous appearance, and mucoid material in the rectal lumen. It is hypointense on T1 with fat saturation, T2, and STIR. It shows intense and homogeneous enhancement on T1 with gadolinium, without being associated with discontinuity of the muscular layer; an interface with the mesorectum and the anterior peritoneal reflection is observed.

Additionally, left external iliac adenopathy was visualized.

Case Discussion

MRI has become the modality of choice when it comes to staging rectal cancer, located up to approximately 15 cm from the anal verge. The MRI facilitates the accurate assessment of mesorectal fascia and the sphincter complex for surgical planning, even helping in the prediction of response to treatment.

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