File:Anal adenocarcinoma - tumor regression grade 1 (Radiopaedia 31358-32103 Axial PRE 56).jpg

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Anal_adenocarcinoma_-_tumor_regression_grade_1_(Radiopaedia_31358-32103_Axial_PRE_56).jpg ‎(512 × 512 pixels, file size: 33 KB, MIME type: image/jpeg)

Summary:

Description
  • Radiopaedia case ID: 31358
  • Image ID: 8576472
  • Image stack position: 56/84
  • Plane projection: Axial
  • Aux modality: PRE
  • Study description: Staging CT pre- and post chemoradiotherapy
  • Study findings: Pre chemoradiotherapy: Abdomen and pelvis: No focal liver lesion. There is a 7 mm soft tissue attenuation exophytic nodule at the upper pole of the left kidney. Spleen, adrenal glands, pancreas appear normal. No free fluid or lymphadenopathy in the abdomen or pelvis. The uterus contains a number of calcifications within the myometrium. The endometrial thickness measures at least 12 mm. There is uncomplicated sigmoid diverticulosis. Some ill-defined soft tissue thickening is seen in the posterior anal canal, apparently extending to the anal cleft. No destructive bone lesion is identified. Conclusion: 1. No evidence of metastatic disease. No convincing rectal lesion, but a low anal lesion with possible extension into the natal cleft is seen. 2. Incidental subcentimeter exophytic nodule at the left kidney suspicious for a small neoplasm; 3. Endometrial thickening. Recommend pelvic ultrasound if clinically appropriate. Post chemoradiotherapy: No evidence of metastasis.
  • Modality: CT
  • System: Gastrointestinal
  • Findings: MR Anal Cancer Staging Multiplanar noncontrast small field of view MR imaging of the pelvis has been obtained. An anal polypoid lesion identified, extending down from the left anal mucosa. This measures 3.8 cm in length. Within the distal half of the anal canal, this lesion involves the mucosa at the 1-2 o'clock position, just touching the internal sphincter. The external sphincter is normal and the intersphincteric plane is preserved. The mesorectum and rectum appear normal. There are no abnormal inguinal lymph nodes. Visible bones are unremarkable. A 1.5 centimeter uterine leiomyoma is shown. In addition, there is increased endometrial thickness at 1.4 centimeters with small cystic spaces within, is seen in previous CT. Conclusion: Low anal canal lesion from the left side, probably just involving internal sphincter at the 1-2 o'clock position superficially at the level of the anal verge (T2). No external sphincter or intersphincteric fat plane involvement identified. No inguinal lymphadenopathy. Endometrial abnormality suspicious for malignancy, requires further evaluation.
Date Published: 16th Oct 2014
Source https://radiopaedia.org/cases/anal-adenocarcinoma-tumour-regression-grade-1
Author Jan Frank Gerstenmaier
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

Licensing:

Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)

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