Transrectal Ultrasound MRI-Fusion Biopsy of Perirectal Mass

Virginia Li; Elisabeth Mclemore; Vikram Attaluri; Rex Parker; David S Finley

doi:10.1089/cren.2020.0016

Transrectal Ultrasound MRI-Fusion Biopsy of Perirectal Mass

J Endourol Case Rep. 2020 Dec 29;6(4):366-369. doi: 10.1089/cren.2020.0016. eCollection 2020.

Authors

Virginia Li¹, Elisabeth Mclemore², Vikram Attaluri², Rex Parker³, David S Finley¹

Affiliations

¹ Department of Urology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.
² Department of Colorectal Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.
³ Department of Radiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.

Abstract

This case report describes the novel use of ultrasound-guided MRI-fusion biopsy to sample an extraluminal perirectal mass. This is a 64-year-old man with a history of pT3N2b mucinous adenocarcinoma of the right colon with metastatic disease to the mesocolic lymph nodes. Two years after initial resection he was found on restaging CT to have a mass measuring ∼4.0 × 4.8 cm superior to the seminal vesicles. Fluorodeoxyglucose (FDG)-positron emission tomography (PET) showed a moderately FDG avid soft tissue mass interposed between the prostate and the rectum. Multiparametric MRI revealed a 6.2 × 4.6 × 2.8 cm heterogeneous lobulated T2 hyperintense mass with enhancement just superior to the seminal vesicles. This mass was unable to be viewed using sigmoidoscopy. Using UroNAV technology, we were able to biopsy the mass in the clinic setting. Biopsy was confirmed as recurrent mucinous adenocarcinoma.

Keywords: UroNAV; image-guided therapy; perirectal mass.

Publication types

Case Reports