50 year old male patient with stage IV rectal cancer. Staging examination. PELVIS:PROSTATE/SEMINAL VESICLES: No definite invasion by tumor.BLADDER: No definite invasion by tumor.LYMPH NODES: There are scattered small mesorectal lymph nodes (image 45, series 601 and 52, series 601). There are non-specific small inguinal lymph nodes.BOWEL, MESENTERY: There is a 2.7 x 3.1 cm (AP x craniocaudal) irregular, circumferential enhancing mass within the upper rectum. Tumor extends beyond the muscularis propria. The tumor appears to infiltrate through the posterior rectal wall and involves the mesorectal fascia posteriorly with signal abnormality extending to the presacral fascia (image 31, series 701 and image 56, series 2001). There is also infiltration of the mesorectal fascia along the right lateral border of the tumor (image 54, series 2001) and abutment of the mesorectal fascia anteriorly. There is no invasion of the bladder. The anal sphincter does not appear to be involved. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Upper rectal mass with extension through the mesorectal fascia as described above.2.Small mesorectal lymph nodes are suspicious for metastatic adenopathy.