Male 53 years old Reason: Rectal cancer please assess and evaluae extent of disease prior to start of therapy History: As above Overall image quality: ExcellentPELVIS:PROSTATE/SEMINAL VESICLES: Tumor abuts the posterior aspect of the prostate with loss of normal fat plane. No gross invasion is evident.BLADDER: No significant abnormality noted. LYMPH NODES: Lymph nodes in the perirectal space, within the mesorectal fascia: Scattered small lymph nodes, largest is 5 x 4 mm (series 13, image 25)Lymph nodes outside the mesorectal fascia: Bilateral pelvic sidewall mildly enlarged lymph nodes, on the right there is a node that is 10 x 9 mm (series 11, image 303).BOWEL, MESENTERY: Rectal Tumor:Size: 4.4 x 2.8 x 5.4 cm (image 25/series 7 and image 23/series 6)Tumor appearance on T2-weighted images: Lobulated T2 intermediate signal intensity mass.Tumor location: Lower-third(For lower rectal tumors):Distance of the lower edge of the tumor to the anal verge (lower edge of the anal canal): 3.9 cm.Distance of the lower edge of the tumor to the pelvic floor (relationship of the tumor to the anal sphincter complex): Tumor extends down to the anus at the level of the puborectalis muscle with suspicion for invasion through the external sphincteric complex on the right at the 10 o'clock position (series 6, image 29)Circumference of the rectum involved: Anterior to left rectal wall (10 o'clock to 4 o'clock position).Relationship and proximity of the tumor to adjacent structures (prostate, seminal vesicles): Abuts the posterior aspect of the prostate (series 6, image 25) without evidence of gross invasion.MRI T-stage: T3Tumor Distance to Mesorectal Fascia: Extends to the mesorectal fascia anteriorly and abuts the posterior prostate (image 25/series 6).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1. Stage T3 lower rectal cancer extending to the anus with suspicion of invasion of the external sphincteric complex.2. Mildly enlarged extramesorectal lymph nodes, suspicious for local metastases. Additional lymph nodes as described above.