Villous adenoma of the rectum
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Case courtesy of Dr Laura Jimenez Juan.
Rectal cancer. The patient is known to have a long segment villous adenoma carpet lesion in the rectum and distal sigmoid.
There is marked circumferential bowel wall thickening extending from the ano-rectal junction to the distal sigmoid approximately 20 cm in length. The maximum wall thickness is 3cm noted at the distal sigmoid. There is no definitive rectal wall , mesorectal fat, urinary bladder or bone invasion.
Long segment of circumferential recto-sigmoid wall thickening, as described.
CT scan (not shown)
There is essentially circumferential and nodular mural thickening of the entire rectum and distal sigmoid colon with frond-like soft tissue projections into the lumen, and proximal shouldering. The abnormality is more than 15 cm long. There is no proximal obstruction. There is no gross invasion into the perirectal fat. There is no lymphadenopathy.
The appearance is consistent with an usually large carpet-like rectal villous adenoma. Certainly an element of carcinoma may well co-exist. This is a limited, unenhanced study but no evidence of metastatic disease is detected. No evidence of metastatic disease on this limited, unenhanced CT.