Rectal carcinoma 3 (deep localization) – Example
Chief complaint in this 79-year-old white male patient was a one-year history of irregular bowel movements. He described the constant variability from diarrhea to constipation as very unpleasant. Over the previous few weeks, he additionally noted weight loss and a general feeling of weakness. There was no fever and no reported night sweats. The patient never reported observing blood in the stool. Chest computed tomography (CT) revealed multiple metastases. Metastases to the liver, however, were not detected by either ultrasound or CT.
The videoclip begins proximal from the rectal tumor. The tumor encompasses the entire circumference and narrows the lumen somewhat. The rectal ampulla shows no endoscopic evidence of tumor. Histology revealed a moderately differentiated G2 adenocarcinoma.
The tumor team recommended primary tumor resection with subsequent palliative chemotherapy. Although lung metastases are not uncommon in primary tumors localized to the mid-rectum, one of the lung metastases was biopsied in order to rule out a second tumor in the lung.