Keywords:
Abdomen, Gastrointestinal tract, Oncology, CT, Staging, Surgery, Cancer
Authors:
X. Chengqian1, X. Zhao2; 1100021/CN, 2Beijing/CN
DOI:
10.1594/ecr2013/C-2528
Results
Symtoms
The most common presentation was rectal bleeding(n=8),followed by tenesmus(n=5) and Dyschezia (n=3) .
CT fingdings
- Mean length of the tumors: 3.1cm(range,1.9~7.7cm); Mean diameter:2.5cm(range,1~7cm).
- Morphology:All of the tumors appeared as polypoid or fungating intraluminal neoplasm(Figure1,3).Peritectal infiltration could be observed in 5 cases.
(Figure1,2,3).
Perirectal infiltration could extended to the presacral space (n=2).
- 3 patients had lymphadenopathy,
involving the perirectal(Figure1),
presacral(Figure3) and iliac vessel lymph node stations.
- Distant metastasis was noted in 2 patients(Figure3).
- There was no evidence of obstruction in any patients.
Treatment
6 underwent abdominoperineal resection,
2 underwent local excision,
1 underwent sigmoid colostomy and 1 underwent adjuvant immunotherapy and chemotherapy.
Pathological findings
Most of the tumors invaded the dentate line confirmed by postoperative pathology (n=6).
All 9 cases underwent surgery stained for HMB-45 and S-100(Figure4).
8 stained for Melan A.
Prognosis
7 died with the median survival time of 24 months (range 8-70months).
1 is undergoing palliative therapy,
approaching her end and 2 are under stable condition 21months and 31months after surgery.