PMC6332972_01
MRI showing the rectal lesion with the perirectal fat stranding.
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MRI showed a rectal mass with circumferential thickening and stranding extending to the pelvic side wall (Figure 1) with multiple large left iliac and mesorectal lymph nodes reaching a size of 2.8 cm. Multiple foci of T2 hyperintensity and enhancement were detected involving the lumbar and sacral spine, both iliac bones, and proximal femura.
Bone scan showing the widespread osseous deposits.
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Bone scan confirmed the widespread active osseous lesions involving the spine, ribs, and pelvic bones (Figure 2).
SPECT-CT showing diffuse bone and bone marrow lesions.
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SPECT-CT suggested diffuse bone infiltration (Figure 3).
Graph showing the hemoglobin (g/dl) and white cell count (K/ml) of the patient during the disease course.
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Between June 1 and 14, he received palliative radiotherapy to the pelvis in a dose of 30 grays over 10 fractions with improvement of the rectal bleeding and was scheduled to start palliative chemotherapy, but the patient became pale and developed progressive and prolonged drop in his hemoglobin and platelet levels (Figures 4 and 5).
Graph showing the platelet count (K/ml) of the patient during the disease course.
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Between June 1 and 14, he received palliative radiotherapy to the pelvis in a dose of 30 grays over 10 fractions with improvement of the rectal bleeding and was scheduled to start palliative chemotherapy, but the patient became pale and developed progressive and prolonged drop in his hemoglobin and platelet levels (Figures 4 and 5).
MRI showing leptomeningeal thickening.
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CT brain showed prominent bilateral hypodense collection more to the left with some linear opacities and diffuse cortical effacement (Figure 6).
MRI showing sphenoidal and ethmoidal mucosal thickening.
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MRI brain showed diffuse meningeal thickening and enhancement with evidence of sphenoidal and ethmoidal mucosal thickening (Figure 7).