title: Solitary rectal ulcer:  ultrasonographic and magnetic resonance imaging patterns mimicking rectal cancer.
abstract: The objective of this study was to analyze a series of solitary rectal ulcer syndrome (SRUS) cases initially diagnosed as rectal cancer. We analyzed all the patients (1996-2008) initially referred to our colorectal unit with a diagnosis of rectal cancer but with a final diagnosis of SRUS. Demographic data, the diagnostic work-up, and treatment details were collected in a prospective database and analyzed retrospectively. Out of the 5035 patients registered in the colorectal unit database, 14 (0.28%) had a final diagnosis of SRUS. Nine of them had an initial diagnosis of rectal cancer. Out of these, six were preoperatively staged with endorectal ultrasound and/or magnetic resonance and were therefore analyzed for this study. Endorectal ultrasound was performed in all six patients and rectal cancer was diagnosed in five of them; MRI was performed in four patients and a diagnosis of rectal cancer was assessed in three of them; rectal cancer was finally ruled out in all cases by deep-forceps macrobiopsies. The incidence of misdiagnosis between SRUS and rectal cancer does not decrease with the regular use of imaging methods. Clinical judgment and deep-forceps macrobiopsies are essential in avoiding an erroneous diagnosis.
authors.affiliation: General Surgery Department, Coloproctology Unit, Hospital Clínico Universitario/INCLIVA, University of Valencia, Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Blanco
authors.forename: Matteo
authors.initials: M
authors.lastname: Frasson
authors.forename: Blas
authors.initials: B
authors.lastname: Flor-Lorente
authors.forename: Miguel
authors.initials: M
authors.lastname: Minguez
authors.forename: Pedro
authors.initials: P
authors.lastname: Esclapez
authors.forename: Eduardo
authors.initials: E
authors.lastname: García-Granero
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012004:Rectal Neoplasms / Q000175:diagnosis; D012007:Rectum / Q000473:pathology; D012189:Retrospective Studies; D014456:Ulcer / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography