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There is tumoural thickening of rectal wall with involvement of the adjacent bladder wall. You can see gas within the lumen of the bladder. There is a communication (fistula) between the lumen of the rectum and that of the bladder. On the delayed phase, intravesical contrast is visible in the tumoural rectum.
There is also a large metastatic lesion to the lower lobe of the right lung.