Reason: 71 year old with rectal cancer. History: NA Overall image quality: GoodPELVIS:UTERUS, ADNEXA: Expansion of the endometrial canal to 38 mm (701:26)BLADDER: No significant abnormality noted. LYMPH NODES: Lymph nodes in the perirectal space, within the mesorectal fascia: Yes: 8 mm (901:40), about 2 mm from the circumferential resection margin. Another prominent node, 9 mm, about 1 mm or less from the superficial resection margin (901:44).Lymph nodes outside the mesorectal fascia: Yes, but nonspecific, along the external iliac chain and right pelvic sidewall, all less than a centimeter.BOWEL, MESENTERY: Rectal Tumor:Size: 2.7 x 2.7 x 4.9 cm (image 25/series 701), 601:34, 2001:30Tumor appearance on T2-weighted images: Slightly hyperintense with areas of even more increased T2 hyperintensity, likely small areas of necrosis. There may be extension outside of the serosa/mild desmoplastic reaction (601:46).Tumor location: Lower and mid rectum(For lower rectal tumors):Distance of the lower edge of the tumor to the anal verge (lower edge of the anal canal): Approximately 4.7 cmDistance of the lower edge of the tumor to the pelvic floor (relationship of the tumor to the anal sphincter complex): Approximately 2.6 cm (701:26) Circumference of the rectum involved: Near completeRelationship and proximity of the tumor to adjacent structures (uterus, cervix, vagina): Separate from, with preserved fat planesMRI T-stage: T3Tumor Distance to Mesorectal Fascia: 1.7 cm (image 39/series 901).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.T3 rectal cancer as above. At least 1 mesorectal lymph node is located within 1 mm of the circumferential resection margin as above.2. Expansion of the endometrial canal to 38 mm suspicious for endometrial cancer given patient's age. Recommend gynecology consult.