Rectal carcinoma 1 (low rectal carcinoma) – Example
This 59-year-old white male patient, who reported recurrent fresh red blood in his stool for a period of a few weeks, was referred by his family physician for endoscopy. The patient had never undergone screening for colorectal cancer. The patient was active and felt healthy. There was no anemia.
The videoclip shows a tumor in the lower rectum about 2-3 cm in diamater, whose center is somewhat depressed and exulcerated. Its margin is only a few centimeters from the anal canal. Histological examination of tissue returned at biopsy revealed an adenocarcinoma. Endosonographic findings indicated infiltration of the tunica muscularis and there were several pararectal lymph nodes enlarged up to 1.5 cm in diamater. Lymph node infiltration was confirmed at surgery.
This patient’s case underscores the importance of screening for colorectal cancer. Some colorectal carcinomas may appear small at endoscopy despite being advanced in terms of spread. The distance to the dentate line should be well documented at endoscopy.