Rectal carcinoma

Case contributed by Dr Chris O'Donnell

Presentation

Mass at anal verge.

Patient Data

Age: 80 years
Gender: Female

We would normally insert rectal gel to outline the lumen, but not in this case given the presence of an anal mass

MRI

Locally advanced rectal cancer invading the mesorectal fat with local and distant lymph node metastases as well as probable extension into the vault of the vagina (on the left) and extension via the anal mucosa out to the right posterior anal verge. Restricted diffusion is seen in the tumor and the local as well as distant lymph nodes. 

Case Discussion

​MRI is the investigation of choice for local staging of rectal cancer. T2-weighted imaging in 3 planes is recommended, parallel and perpendicular to the long axis of the rectum.

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