Female 43 years old Reason: Please follow protocol IRB # 14-0288. Rectal cancer, please assess extent of disease state post induction therapy with Chemo and radiation, RECIST compare to previous MRIs, prior to planned potential surgery. History: Additional history as per chart, patient has history of tumor palpable approximately 3 to 4 cm proximal to the anal verge. PELVIS:UTERUS, ADNEXA: There is a 1.5 cm left adnexal cyst, otherwise the uterus and adnexa are unremarkable. BLADDER: The bladder appears normal.LYMPH NODES: Lymph nodes in the perirectal space, within the mesorectal fascia: NoneLymph nodes outside the mesorectal fascia: Subcentimeter inguinal lymph nodes. No suspicious lymphadenopathy.BOWEL, MESENTERY: Rectal Tumor:Size: 1.8 x 1.3 cm in greatest thickness (series 3, image 42) approximately 3.2 cm from the anal verge.Tumor appearance: The tumor demonstrates low T2 signal and is predominantly circumferential. Additionally, there are areas in which the serosal lining of the rectum is not well visualized (series 3, image 30). There is minimal enhancement of the thickened bowel wall.Tumor location: The tumor extends from 3.2 cm from the anal verge proximally to the sigmoid colon (series 3, image 26).Circumference of the rectum involved: The tumor is circumferential.Relationship and proximity of the tumor to adjacent structures (uterus, cervix, vagina): There is no involvement of the mesorectal fat or fascial.MRI T-stage: T3BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of pelvic free fluid is noted, likely physiologic.
Circumferential rectal wall thickening and signal abnormality representing rectal carcinoma with likely posttreatment changes. Although the serosal surface appears to be involved, the mesorectal fascia and adjacent organs are spared.