Description

A 46-year-old male has a recent history of rectal adenocarcinoma ypT3N1M0G2, treated by neoadjuvant radio-chemotherapy, low anterior rectal resection and adjuvant chemotherapy. Before surgery a thoraco-abdominal CT showed no other pathological lesion. The patient presented free of symptoms 6 months after surgery for follow-up visit, had no fever and normal values at routine laboratory evaluation. The thoraco-abdominal CT identified a cystic lesion with thin wall in the apical segment of the right inferior lobe of 2.5 cm diameter, not seen at previous radiological assessment (figure 1), with no thoracic lymphadenopathy and without signs of abdominal disease; it was considered that colonoscopy was not necessary at the time. The cystic lesion was interpreted initially of unknown origin, the patient presenting neither inflammatory signs nor respiratory symptoms. His metastatic origin could not be ruled out at the time, the carcinoembryonic antigen being normal. The patient was followed strictly and 6 months later a new CT (figure 2) showed growth in size of the …