Using Materialise's interactive medical image control system to reconstruct a model of a patient with rectal cancer and situs inversus totalis: A case report

Table 1 Timeline

Date	Clinical treatment course
August 6, 2018	The patient reported intermittent bloody stool for approximately 6 mo that became aggravated in recent days. And then, the patient underwent a physical examination, in which digital rectal examination revealed that a mass was about 5 cm above the anal verge, and the tip of the glove was stained with blood
August 16, 2018	Abdominopelvic contrast-enhanced computed tomography scans revealed that a soft tissue mass, approximately 4.5 cm from the lower rectum to the anus, was irregularly infiltrated into the serous membrane. The mass was seen to protrude into the lumen, with metastatic lymph nodes detected around. Colonoscopy showed a palpable encircling mass in the lower rectum, 10-13 cm above the anal verge. Part of the mass was sent for biopsy
August 20, 2018	After hospitalization, relevant examinations were further made to the patient to clarify the diagnosis. Laboratory findings showed that the occult blood test was positive, plasma D-dimer level was 0.81 mg/L fibrinogen equivalent unit, and the potassium ion concentration in serum was 3.48 mmol/L
August 21, 2018	Chest posterior-anterior radiograph and electrocardiographic examination showed dextrocardia
August 23, 2018	MRI scans (3.0T) revealed that a soft tissue mass, approximately 70 mm from the lower rectum to the anus, was irregularly infiltrated into the serous membrane. The mass was seen to protrude into the lumen, with metastatic lymph nodes detected around. No absolute operation contraindication was found in the preoperative examinations. Before surgery, we reconstructed a 3D model of organs with Mimics, which helped preoperative plans. Laparoscopy-assisted radical resection of rectal cancer with distal ileostomy was performed successfully under general anesthesia
August 28, 2018	Postoperative pathological examination showed differentiated colorectal adenocarcinoma invading into the full wall of the bowel. No cancer residues were found in the incised edge of either side, and the circumferential edge was 1 mm away from the tumor. The lymph nodes (LN1, LN2, and LN3) showed no metastasis of the tumor tissue (0/16, 0/8, and 0/6)
September 29, 2018	Adjuvant chemotherapy with the XELOX regimen (oxaliplatin + Xeloda) was initiated 1 mo after the operation. The patient recovered well after surgery, and her physical condition remains stable

Table 2 List of situs inversus associated with rectal cancer

Author	Yr	Age/sex	Tumor	Journal
Huh et al[4]	2010	41/female	Rectal cancer	J Korean Med Sci
Choi et al[5]	2011	43/male	Rectal cancer	Surg Laparosc Endosc Tech
Fang et al[6]	2015	39/female	Rectal cancer	J Minimal Access Surg
This case	2019	68/female	Rectal cancer