Female 73 years old Reason: rectal adenocarcinoma staging History: as above Overall image quality: GoodPELVIS:UTERUS, ADNEXA: Uterus is surgically removed or atrophic.BLADDER: No significant abnormality noted. LYMPH NODES: At least 5 scattered mesorectal fascial lymph nodes, largest measuring up to 6 mm.BOWEL, MESENTERY: Rectal Tumor:Circumferential involvement of an approximately 7.1 cm (image 30/series 1001) segment of rectosigmoid colon. This tumor signal likely extends at least to the muscularis layer with possible minimal extension into the mesorectal fat, T3.Tumor appearance on T2-weighted images: Grey, circumferentialTumor location: Begins at the upper anal sphincter about 2.7 cm from the anal verge.Relationship and proximity of the tumor to adjacent structures (uterus, cervix, vagina): In the same image described immediately below where it extends to the anterior where the tumor extends to the anterior mesorectal fascia, the posterior vaginal wall is also adjacent to the signal abnormality, but has a relatively preserved plane. Some gray signal extending into the wall may be desmoplastic reaction, but underlying tumor is not excluded.Tumor Distance to Mesorectal Fascia: Extending directly to the anterior mesorectal fascia (axial oblique series 801:37)BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Few nonspecific prominent bilateral inguinal lymph nodes. A couple nonspecific right external iliac subcentimeter lymph nodes. The aortic bifurcation is not imaged but there are no common iliac lymph nodes.
1.Approximately 7 cm long rectosigmoid T3 tumor with several associated mesorectal lymph nodes (>5) and less than 1 mm mesorectal fascial margin as described above. Minimal involvement of the posterior vaginal wall cannot entirely be excluded as above.