The Use of Endoscopic Ultrasonography and Other Imaging Modalities in the Preoperative Staging of Rectal Villous Tumours: A Case of Overstaging by Magnetic Resonance Imaging

A case of a 60-year-old man with recurrent rectal villous adenoma is described. Preoperative staging with endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) revealed very discordant results. EUS showed a tumour present in the mucosa with no submucosal invasion, while MRI revealed invas...

Full description

Saved in:
Bibliographic Details
Main Authors: Michelle Buresi, Iman Zandieh, Alexander G Nagy, Audrey Spielmann, William C Yee, Alan A Weiss, Eric M Yoshida
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2009/750979
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849693711840051200
author Michelle Buresi
Iman Zandieh
Alexander G Nagy
Audrey Spielmann
William C Yee
Alan A Weiss
Eric M Yoshida
author_facet Michelle Buresi
Iman Zandieh
Alexander G Nagy
Audrey Spielmann
William C Yee
Alan A Weiss
Eric M Yoshida
author_sort Michelle Buresi
collection DOAJ
description A case of a 60-year-old man with recurrent rectal villous adenoma is described. Preoperative staging with endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) revealed very discordant results. EUS showed a tumour present in the mucosa with no submucosal invasion, while MRI revealed invasion of the muscularis propria consistent with an invasive stage T2 carcinoma. Based on the MRI findings, the patient underwent a low anterior resection of the tumour. The surgical pathology specimen revealed a villous adenoma with low-grade dysplasia but no carcinoma and no extension into the muscularis propria. The present case highlights the uncertainty that currently exists as to which imaging modality provides the greatest accuracy in the staging of rectal cancer and in guiding the type of surgical procedure performed. Two recent meta-analyses and a systematic review of the literature point to EUS as the imaging modality of choice for determining muscularis propria and perirectal tissue invasion, as well as nodal involvement.
format Article
id doaj-art-55e62338fde74c3b86c33a1d1c1e33b7
institution DOAJ
issn 0835-7900
language English
publishDate 2009-01-01
publisher Wiley
record_format Article
series Canadian Journal of Gastroenterology
spelling doaj-art-55e62338fde74c3b86c33a1d1c1e33b72025-08-20T03:20:19ZengWileyCanadian Journal of Gastroenterology0835-79002009-01-0123963964110.1155/2009/750979The Use of Endoscopic Ultrasonography and Other Imaging Modalities in the Preoperative Staging of Rectal Villous Tumours: A Case of Overstaging by Magnetic Resonance ImagingMichelle Buresi0Iman Zandieh1Alexander G Nagy2Audrey Spielmann3William C Yee4Alan A Weiss5Eric M Yoshida6Department of Medicine, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Medicine, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Surgery, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Surgery, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Radiology, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Medicine, University of British Columbia, Vancouver, British Columbia, CanadaDepartment of Medicine, University of British Columbia, Vancouver, British Columbia, CanadaA case of a 60-year-old man with recurrent rectal villous adenoma is described. Preoperative staging with endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) revealed very discordant results. EUS showed a tumour present in the mucosa with no submucosal invasion, while MRI revealed invasion of the muscularis propria consistent with an invasive stage T2 carcinoma. Based on the MRI findings, the patient underwent a low anterior resection of the tumour. The surgical pathology specimen revealed a villous adenoma with low-grade dysplasia but no carcinoma and no extension into the muscularis propria. The present case highlights the uncertainty that currently exists as to which imaging modality provides the greatest accuracy in the staging of rectal cancer and in guiding the type of surgical procedure performed. Two recent meta-analyses and a systematic review of the literature point to EUS as the imaging modality of choice for determining muscularis propria and perirectal tissue invasion, as well as nodal involvement.http://dx.doi.org/10.1155/2009/750979
spellingShingle Michelle Buresi
Iman Zandieh
Alexander G Nagy
Audrey Spielmann
William C Yee
Alan A Weiss
Eric M Yoshida
The Use of Endoscopic Ultrasonography and Other Imaging Modalities in the Preoperative Staging of Rectal Villous Tumours: A Case of Overstaging by Magnetic Resonance Imaging
Canadian Journal of Gastroenterology
title The Use of Endoscopic Ultrasonography and Other Imaging Modalities in the Preoperative Staging of Rectal Villous Tumours: A Case of Overstaging by Magnetic Resonance Imaging
title_full The Use of Endoscopic Ultrasonography and Other Imaging Modalities in the Preoperative Staging of Rectal Villous Tumours: A Case of Overstaging by Magnetic Resonance Imaging
title_fullStr The Use of Endoscopic Ultrasonography and Other Imaging Modalities in the Preoperative Staging of Rectal Villous Tumours: A Case of Overstaging by Magnetic Resonance Imaging
title_full_unstemmed The Use of Endoscopic Ultrasonography and Other Imaging Modalities in the Preoperative Staging of Rectal Villous Tumours: A Case of Overstaging by Magnetic Resonance Imaging
title_short The Use of Endoscopic Ultrasonography and Other Imaging Modalities in the Preoperative Staging of Rectal Villous Tumours: A Case of Overstaging by Magnetic Resonance Imaging
title_sort use of endoscopic ultrasonography and other imaging modalities in the preoperative staging of rectal villous tumours a case of overstaging by magnetic resonance imaging
url http://dx.doi.org/10.1155/2009/750979
work_keys_str_mv AT michelleburesi theuseofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT imanzandieh theuseofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT alexandergnagy theuseofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT audreyspielmann theuseofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT williamcyee theuseofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT alanaweiss theuseofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT ericmyoshida theuseofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT michelleburesi useofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT imanzandieh useofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT alexandergnagy useofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT audreyspielmann useofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT williamcyee useofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT alanaweiss useofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging
AT ericmyoshida useofendoscopicultrasonographyandotherimagingmodalitiesinthepreoperativestagingofrectalvilloustumoursacaseofoverstagingbymagneticresonanceimaging