Rectosigmoid colon cancer

Case contributed by Dr MT Niknejad

Presentation

Abdominopelvic pain and chronic constipation.

Patient Data

Age: 45 years
Gender: Male
MRI

Increased wall thickening in favor of tumoral infiltration is noted at proximal part of rectum and rectosigmoid junction, accompanied by pericolic fat stranding and a few small suspicious lymph nodes with maximum SAD of 6 mm.
Distance between lower margin of lesion to anorectal angle is about 80 mm. Mesorectal fascia and peritoneal reflection are intact.
A little free fluid is seen at pelvic cavity.

Post surgical barium enema for evaluation of anastomotic site

Barium

Post operative changes are seen due to distal partial colectomy and colorectal anastomosis. There is no obvious stricture in anastomotic site or evidence of contrast media leakage.

Post surgical control CT scan after 6 months

CT

Post-operative changes are seen due to rectosigmoid resection and colorectal anastomosis. There are no sign of local tumoral recurrence at anastomotic site and no regional lymphadenopathy.
A few non-enhanced simple cortical cysts are seen at both kidneys, with maximum diameters of 15 mm. 
The prostate gland is enlarged.
Degenerative changes as osteophytes are seen at the lumbar spine.

Case Discussion

Rectosigmoid mass (pathology proven adenocarcinoma) with small regional lymphadenopathies.

Colorectal cancers can be found anywhere from the cecum to the rectum. Rectosigmoid involvement includes about 55% of cases as the most common site of colorectal cancer. 

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