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...
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| Format: | Article |
| Language: | English |
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Wiley
2009-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2009/750979 |
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| 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 |
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