Introduction: Preoperative imaging staging of colorectal cancer is essential for optimal therapeutic planning. Multidetector computed tomography (MDCT) is the standard imaging modality for initial staging; however, its diagnostic accuracy in assessing tumor depth and nodal status remains debated.

Objective: To evaluate the diagnostic accuracy of MDCT in preoperative T and N staging of colorectal cancer by comparison with operative and histopathological findings as the reference standard.

Methods: A retrospective analysis was conducted in 63 patients with histopathologically confirmed colorectal cancer who underwent preoperative contrast-enhanced CT of the abdomen and pelvis. CT-based assessment of T and N stages was compared with operative and histopathological findings. Agreement was evaluated using appropriate statistical methods.

Results: MDCT demonstrated the highest diagnostic accuracy in identifying T3 tumors. Overall agreement between CT and histopathological findings for individual T stages was low but statistically significant (Kappa = 0.166; p = 0.049), with a predominant tendency toward understaging. When T stages were grouped into low (T1–T2) and high (T3–T4) categories, diagnostic accuracy reached 71.4%. Nodal staging with morphological status showed high agreement in binaryclassification  (Kappa = 0.682; p < 0.001), but limited reliability acording to size of lymph node

Conclusion: MDCT shows good diagnostic performance in preoperative T staging of colorectal cancer, particularly in advanced stages, while nodal staging remains limited and requires cautious interpretation.

We present the case of a 46-year-old patient diagnosed with a large solid tumor localized in the right mesentery, and due to the mesenteric position and tumor structure, diagnostic suspicion of GIST was proposal as the most frequent tumor lesion of this localization. After a few days, the patient was discharged from the hospital without postoperative complication, in further follow-up without relapse.