Rectosigmoid carcinoma with hepatic metastases
Abdominal pain, constipation, and cachexia. Ultrasonography showed focal hepatic lesions.
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- The rectosigmoid shows a 7 cm segment of diffuse mural thickening and enhancing irregular soft tissue mass lesion with luminal narrowing, as well as infiltration of the pelvic fat planes. There are enlarged pericolic lymph nodes with a globular shape, largest is 17 x 16 mm.
- Spiculated, enhancing soft tissue mass lesion anterior to the upper sacrum encasing the distal inferior mesenteric artery, likely representing amalgamated nodal tissue. It measures 4.3 x 3.2 cm.
- Enlarged para-aortic, common iliac, external and internal iliac lymph nodes, the largest is a left para-aortic node measuring 2.8 x 2.3 mm.
- The liver is average-sized with diffuse low attenuation of its parenchyma. Multiple heterogeneously-enhancing hepatic focal lesions in both liver lobes with continuous marginal enhancement, the largest is seen at the left lobe measuring 9 x 8.5 x 6 cm.