PMC4959932_01
Ulcerated lesion of the rectum found at endoscopy (black arrow).
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On colonoscopic investigation, an ulcerated lesion on the right rectal wall extending 4 cm up from the anal verge was found along with a submucosal nodule that was tentatively thought to be a lymph node (see Fig. 1).
CT of the chest showing multiple bilateral lung nodules (white and black arrows).
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Computed tomography (CT) of the chest, abdomen and pelvis showed bilateral lung nodules measuring up to 1.4 cm and multiple peri-rectal nodules up to 2.3 cm in diameter (see Fig. 2, Fig. 3).
Sagittal view of pelvic MRI showing rectal mass with invasion of levator ani muscle and satellite nodules of the peri-rectal fat and base of the penis (white arrows).
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Magnetic resonance imaging (MRI) of the pelvis demonstrated an ano-rectal tumor extending 5.5 cm from the anus with invasion of the levator ani muscle and satellite nodules at the base of the penis and in the peri-rectal fat (see Fig. 4).