Tubulovillous adenoma - rectum

Case contributed by Dr Ammar Haouimi

Presentation

Rectal bleeding with a rectal mass on colonoscopy.

Patient Data

Age: 60 years
Gender: Female

The MRI sequences demonstrate a posterior polypoidal hemicircumferntial thickening of the mid-and lower third of the rectum (craniocaudal length = 9 cm, maximum wall thickness = 5 cm) with a distal edge 3.5 cm from the anal verge. It displays an intermediate signal intensity on both T1, and T2 with vivid heterogeneous enhancement on postcontrast sequences, and restricted diffusion on DWI/ADC. The villi are well-visualized on T2 sequences with surrounding fluid. The muscularis propria seems to be involved at the base of the pedicle at 5 o'clock with no evidence of extramural extension. No perirectal or iliac lymphadenopathy is seen. 

 

 

Case Discussion

MRI features of a polypoidal tumoral process of the rectum, pathologically proven as tubulovillous adenoma.

 

Additional contributor; ZE. Boudiaf, MD, CHU Constantine, Algeria

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