Male 68 years old Reason: local staging History: metastatic Rectal cancer, s/p liver resection, s/p chemoradiation therapy per chart. Overall image quality: GoodPELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted. LYMPH NODES: Lymph nodes in the perirectal space, within the mesorectal fascia: There are several non-specific subcentimeter lymph nodes within the mesorectal fascia.Lymph nodes outside the mesorectal fascia: Non-specific prominent left external iliac lymph node measuring 1.1 x 0.5 cm (series 5 image 20).BOWEL, MESENTERY: Rectal Tumor: There is irregularly-shaped soft tissue extending posterolaterally left greater than right from the rectum to the mesorectal fascia and abutting it. It is very low signal intensity on T2-weighted imaging sequences.Size: The signal abnormality is difficult to accurately measure but involves approximately 2.8 x 2.4 x 4.3 cm (series 5 image 44 and series 6 image 43).Tumor appearance on T2-weighted images: Very low signal intensity.Tumor location: Middle-thirdRelationship and proximity of the tumor to adjacent structures (prostate, seminal vesicles): The signal abnormality is posterolateral without involvement of the prostate or seminal vesicles.BONES, SOFT TISSUES: Prominent left greater than right inguinal lymph nodes. No suspicious discrete osseous abnormality.OTHER: No significant abnormality noted.
1.Irregular soft tissue extending posterolaterally left greater than right from the mid rectum to the mesorectal fascia and abutting it. Given the dark signal intensity of the lesion posttreatment related fibrosis is favored.2.Nonspecific prominent left external iliac lymph node and subcentimeter mesorectal lymph nodes.3.Nonspecific prominent left greater than right inguinal lymph nodes.