Male; 65 years old. Reason: Please evaluate stage of disease in patient with probable rectal cancer. Please comment on the location of the disease relative to the peritoneal reflection. History: anemia, abdominal discomfort, hepatic mass likely abscess. Overall image quality: FairPROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted. LYMPH NODES: Lymph nodes in the perirectal space, within the mesorectal fascia: 9 x 8 mm lymph node in the right posterior mesorectal fascia on series 4, image 22. Lymph nodes outside the mesorectal fascia: Scattered bilateral external iliac lymph nodes are noted. BOWEL, MESENTERY: Rectal Tumor:Size: 5.9 x 4.7 x 3.0 cm (image 25/series 4, image 19/series 5)Tumor appearance on T2-weighted images: Predominantly solid lesion with intermediate signal intensity. Tumor location: Upper and middle third(For lower rectal tumors):Distance of the lower edge of the tumor to the anal verge (lower edge of the anal canal): 4 cm (series 5, image 20). Distance of the lower edge of the tumor to the pelvic floor (relationship of the tumor to the anal sphincter complex): 4 cmCircumference of the rectum involved: 180 degreesRelationship and proximity of the tumor to adjacent structures (prostate, seminal vesicles): Does not invade prostate or seminal vesicles. MRI T-stage: T3b - Tumor invades 0.5cm to 1cm into perirectal fat or extramural.Tumor Distance to Mesorectal Fascia: 1.0 cm (image 25/series 4).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Extensive sigmoid diverticulosis. Dilated, blind-ending tubular structure extending into the pelvis likely represents a dilated appendix (series 4, image 17). This structure demonstrates restricted diffusion and some associated inflammatory changes.
1.Limited exam demonstrates asymmetric rectal wall thickening/soft tissue mass, compatible with rectal neoplasm at this site. Please see staging measurements above. 2.Abnormally dilated appendix with surrounding inflammation as described above. 