Presentation
A recently diagnosed case of low rectal cancer for CT staging.
Patient Data
At least two small pulmonary nodules are seen, with the smaller one in the middle lobe measuring 0.5 cm and the largest one seen in the left lower lobe measuring about 0.8 cm.
No suspicious mediastinal, hilar or axillary lymphadenopathy seen.
Small tiny right supraclavicular lymph nodes are noted for ultrasound correlation.
The liver is average size but shows multiple hypodense focal lesions scattered throughout both lobes with the largest of these being in segment VIII, measuring about 2.6x2.3 cm, suggestive of metastasis.
Unremarkable CT features of gallbladder, CBD, portal vein, pancreas, spleen, adrenals, kidneys and urinary bladder.
No size significant para-aortic lymphadenopathy was seen.
No ascites.
Multiple non-complicated diverticula of the large bowel. High density rectal contrast related artifact obscures the lower rectum.
The known cancer in the rectum is seen as a circumferential mass lesion, mainly on the right rectal wall, about 5.0 cm in length and away from the anal verge. Mild perirectal fatty stranding reaching the mesorectal fascia, with a few tiny lymph nodes, the largest on the right side suggesting stage IV.
The visualized bony skeleton shows mild degenerative changes but no suspicious lesions are seen.
Case Discussion
This patient was recently diagnosed with rectal cancer by colonoscopy and biopsy as adenocarcinoma. Multiple hepatic focal lesions and lung nodules suggestive of metastasis, consistent with stage IV disease.
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