Rectal cancer with metastases

Case contributed by Dr Safwat Mohammad Almoghazy

Presentation

A recently diagnosed case of low rectal cancer for CT staging.

Patient Data

Age: 65 years
Gender: Male
CT

At least two small nodules seen the smallest one in the middle lobe 0.5cm and the largest one seen in the left lower lobe measuring about 0.8 cm.

There is no suspicious mediastinal, hilar or axillary lymphadenopathy seen.

Small tiny right supraclavicular lymph nodes are noted for ultrasound correlation.

The liver is average size and showing multiple hypodense focal lesions scattered in both lobes, the largest in segment VIII measuring about 2.6x2.3cm, suggestive of metastasis.

Unremarkable CT features of gallbladder, CBD, portal vein, pancreas, spleen, adrenals, kidneys and urinary bladder.

No sizable and pathological periaortic lymphadenopathy was seen.

No ascites have seen.

The visualised large bowel showing multiple non-complicated diverticula and high density positive rectal contrast making some artefacts masking the lower rectum.

The known cancer rectum is seen as a circumferential mural wall mass lesion seen mainly on right rectal wall, about 5.0 cm length and away from the anal verge. Mild perirectal fatty stranding reaching the mesorectal fascia and a few tiny lymph nodes, the largest on the right side suggesting stage IV.

The visualised osseous structures showing mild degenerative changes with no suspicious lesions seen.

Case Discussion

This case recently diagnosed with rectal cancer by colonoscopy and biopsy as adenocarcinoma and showing multiple hepatic focal lesions and lung nodules suggesting of metastasis consistent with stage IV

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Case information

rID: 50713
Case created: 18th Jan 2017
Last edited: 23rd Jun 2017
Inclusion in quiz mode: Included

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