Laparoscopic open or laparoscopic hybrid approaches are techniques that can be used in suitable patients. Both have acceptable morbidity and mortality.
Rectal malignant tumours may have an unexpected histologyColorectal lymphoma (CRL) commonly affects males from age 50 to 70, 1 and is associated with inflammatory bowel disease, coeliac disease and immunosuppression. 2 Primary rectal lymphoma (PRL) is rare and accounts for 0.05% of all primary rectal malignancies. 3 It is a form of extranodal lymphoma originating from solid organs. While the gastrointestinal (GI) tract is the most common site of extranodal lymphoma, lymphoma of the colon and rectum account for less than 10% of all GI lymphomas. 1 We present a
Background
Accurate staging for rectal cancer is pertinent with recent introduction of rectum‐sparing approaches for patients showing complete clinical response on restaging. Positron emission tomography(PET) is used in detection of recurrence or metastasis, but its value in routine preoperative rectal cancer staging remains unclear. Studies report that preoperative PET altered the stage in 39% and changed the management in 17–27% of patients. Our study aims to look at the utility of PET in routine preoperative staging of rectal cancer within 2 two colorectal units, and to determine if PET did result in a change in management.
Methods
Patients in Nepean Hospital (NSW) and Peter MacCallum Cancer Centre (VIC) who were diagnosed with rectal cancer between 1 January 2017 and 31 December 2021 were included in this retrospective study. All patients who did not have a PET scan were excluded. PET scan results were then compared with MRI and CT results.
Results
Three hundred and fifty‐seven patients were included in the study. 30.3% of the patients had Stage 3 rectal cancer. 71.7% received neoadjuvant therapy. PET scan provided additional information in 55.5% of patients when compared with CT and MRI alone; 18.2% of the PET findings resulted in an altered management for the patient.
Conclusion
PET scan can be a valuable tool in accurate staging, especially for ambiguous or equivocal lesions on CT. Our study demonstrated that additional information from PET scan resulted in an altered management plan in 18.2% of the patients. PET/MRI as a newer modality may be more accurate with reduced radiation exposure.
A 65-year-old female underwent surveillance imaging for metastatic non-small cell lung cancer, with an incidental discovery of new mural thickening of the caecum on computed tomography (CT) imaging. (Fig. 1). Prominent lymph nodes were also seen in this region. The patient was otherwise asymptomatic from her bowel perspective. A colonoscopy was performed to further interrogate the caecum which demonstrated a fungating, malignant-appearing circumferential lesion
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