Rectal cancer staging. PELVIS:UTERUS, ADNEXA: Status post hysterectomy. The mass is suspected to involve the vaginal cuff. BLADDER: There is mass effect on the posterior wall of the urinary bladder by the large rectal mass without evidence of frank invasion. The lesion abuts the posterior bladder wall (series 4/21).LYMPH NODES: Locoregional and pelvic lymphadenopathy. 2.5 x 1.9 cm lymph node at the aortic bifurcation (series 3 image 6). Left external iliac lymphadenopathy measuring 2.3 x 1.7 cm (series 3 image 12).BOWEL, MESENTERY: There is asymmetric circumferential thickening of the distal rectosigmoid colon with a large multilobulated exophytic component. The inferior margin is approximately 9 cm from the anal verge and it measures 8.6 x 6.8 cm in cross-section demonstrating T2 weighted heterogeneous signal intensity (series 3/25). In the craniocaudal dimension the mass extends 7.8 cm (series 4 image 19). The mass extends beyond the mesorectal fascia most significantly along the left anterolateral aspect. The mesorectal fascia has nodular soft tissue thickening as well (series 3 image 32). The mass demonstrates a peripheral thick rind of enhancement with central regions of nonenhancement compatible with necrosis and demonstrates marked restricted diffusion.There are numerous adjacent pathologic lymph nodes and regional lymphadenopathy as described above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Distal rectosigmoid colon mass with a large exophytic component with locoregional and pelvic lymphadenopathy. The lesion abuts the posterior wall of the bladder and is suspected to involve the vaginal cuff. 