Male 58 years old with 4 cm fungating mass 10 cm from anal verge on colonoscopy, pathology confirms rectal adenocarcinoma. Assess for depth and lymph node involvement. Overall image quality: ExcellentPELVIS:PROSTATE/SEMINAL VESICLES: There is a lesion within the right prostate involving the right peripheral zone measuring 7 x 6 mm (image 36/series 4) which is dark on T2 and ADC.BLADDER: No significant abnormality noted. LYMPH NODES: Lymph nodes in the perirectal space, within the mesorectal fascia: There are a few enhancing lymph nodes measuring up to 5 mm (image 147 and 150/series 10011).Lymph nodes outside the mesorectal fascia: No abnormal appearing lymph nodes.BOWEL, MESENTERY: Rectal Tumor:Size: 2.3 x 1.0 x 4.3 cm (image 51/series 4; image 27/series 7)Tumor appearance on T2-weighted images: Predominantly solid lesion with intermediate signal intensity. There is intermediate signal intensity extending into the fat posterior to the rectal wall.Tumor location: Upper thrid of the rectum involving the posterior rectal wall with its inferior margin approximately 8 cm from the verge.Circumference of the rectum involved: 180 degrees posteriorly.Relationship and proximity of the tumor to adjacent structures (prostate, seminal vesicles): Not involved.MRI T-stage: T3b - Tumor invades 0.5cm to 1cm into perirectal fat or extramural.Node Distance to Mesorectal Fascia: 4 mm (image 49/series 12).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Predominantly solid tumor in the upper third of the rectum involving the posterior rectal wall has evidence of invasion into the perirectal fat. There are abnormally enhancing lymph nodes within the mesial rectal fascia suspicious for metastasis.2.A lesion within the right peripheral zone is suspicious for prostate carcinoma.