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Rectal adenocarcinoma

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain

Presentation

Workup for pelvic pain and chronic constipation.

Patient Data

Age: 35 years
Gender: Male
ct

Increased wall thickness due to tumoral infiltration is noted at superior part of the rectum and rectosigmoid junction, accompanied by perirectal fat stranding.

Several perirectal enlarged lymph nodes with a maximum SAD of12 mm are seen.

The mesorectal fascia seems to be involved on the right side.

mri

Infiltrative enhancing mass is noted at the rectosigmoid junction and proximal of the rectum. Additionally, an 18 mm ingrowth into the mesorectal fat and mesorectal fascia involvement are seen at the right lateral aspect. The distance between the lower border of the lesion and the anorectal angle is about 65 mm.

There are several enlarged lymph nodes in the mesorectal space.

Case Discussion

Rectal mass; pathology proved adenocarcinoma with mesorectal fascia involvement and regional enlarged lymph nodes

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.

CT is the modality most used for staging colorectal carcinoma; however, MRI is the preferred modality for the staging of rectal cancer.

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