Seventy-four year old man with history of rectal carcinoma. Receives neoadjuvant chemo-radiotherapy (QT/RT) before surgery.
CT examination of abdomen and pelvis showed a mass with exofitic component in left postero-lateral aspect of rectum and a small adjacent lymph node (1 cm).
Chest-Rx showed increased left pleural effusion and basal atelectasia already observed a year before.
The patient is operated the following month, being with ileosthomy thereafter.
Pathology showed rectal ulcerative lesion 7x8x3 cm corresponding to a carcinoma of tubular type with mucinous focal component, lymphatic invasion, infiltrative margin and no evidence of blood vessel invasion, with 2/3 positive lymph nodes.
Conclusion: colon Ca - Dukes C Group C2 (Astler & Coller), Group III (Jass). (More clinical history in the cases)
Teaching points:
PET-FDG can be used for initial staging and restaging in rectal carcinoma.
PET-FDG can help clarify the origin of new CT findings.
