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What should be the next course of action based on the pelvic MRI?

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Patient's Query

Hi doctor,

I have an asymptomatic with incidental following findings in MRI. A well-defined thin-walled cystic lesion is seen in the left pararectal space, appearing heterogeneously hyperintense on T1 and hyperintense on T2W images, suggestive of the hemorrhagic cystic lesion. The core of the lesion also reveals diffusion restriction. Antero-medially there is also a T2 hypointense solid component. Its dimensions are approximately 6.6 cm SI x 6.3 cm RL x 6.4 cm AP in size. This lesion is in close relation to the left lateral wall of the rectum, with slight effaced fat planes. It is located infero-medially to the tip of the coccyx. Fat planes of the lesion with the piriformis muscle and the sciatic nerve are maintained. There was no evidence of extension into the gluteal region. Can you please tell me what should be the next course of action?

Answered by Dr. Ajeet Kumar

Education:

MBBS

Professional Bio:

Dr. Ajeet Kumar is a dedicated Physician specializing in gastrointestinal and liver disorders. He focuses on diagnosing and managing a wide range of digestive conditions with a patient-centered and evidence-based approach. His clinical interest includes promoting long-term digestive wellness through accurate evaluation, timely intervention, and personalized care, ensuring patients receive comprehensive support for their overall health and well-being.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

Well, the description is not specific for a particular diagnosis. A radiologist is the best person to diagnose based on the findings on the MRI (magnetic resonance imaging).

Given the location in the rectum wall, there is a possibility of a gastrointestinal stromal tumor or leiomyosarcoma or a benign lesion like a diverticular abscess.

The best next step is sigmoidoscopy and biopsy. If EUS (endoscopic ultrasound)-guided biopsy is possible in your hospital, then go for it. Otherwise, a radiologist can do an ultrasound-guided biopsy and confirm the diagnosis.

Regards.

Medically reviewed by Dr. Sneha Kannan
Published At September 5, 2020
Reviewed At March 2, 2026

Education:

MBBS

Professional Bio:

Dr. Ajeet Kumar is a dedicated Physician specializing in gastrointestinal and liver disorders. He focuses on diagnosing and managing a wide range of digestive conditions with a patient-centered and evidence-based approach. His clinical interest includes promoting long-term digestive wellness through accurate evaluation, timely intervention, and personalized care, ensuring patients receive comprehensive support for their overall health and well-being.

This doctor is not available for online consultations on the platform anymore.

Education:

BDS

Professional Bio:

Dr. Sneha Kannan is a skilled Dental Surgeon with expertise in providing general dental care, including scaling, fillings, and preventive treatments. She does oral surgery procedures such as extractions and minor surgical interventions. She does procedures in restorative dentistry, including crowns, bridges, and dentures. She is an expert in doing endodontic treatments such as root canal therapy. She is well-versed in doing procedures in cosmetic dentistry, including teeth whitening and smile correction. She can provide pediatric dental care for children’s oral health and preventive treatments. She promotes oral hygiene awareness and preventive dental practices.  

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. Ajeet Kumar is a dedicated Physician specializing in gastrointestinal and liver disorders. He focuses on diagnosing and managing a wide range of digestive conditions with a patient-centered and evidence-based approach. His clinical interest includes promoting long-term digestive wellness through accurate evaluation, timely intervention, and personalized care, ensuring patients receive comprehensive support for their overall health and well-being.

This doctor is not available for online consultations on the platform anymore.

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