Date of Presentation

5-3-2018 8:00 AM

College

School of Osteopathic Medicine

Poster Abstract

Colorectal cancer is the second leading cause of cancer-related deaths in the United States amongst cancers that affect both genders. Synchronous colorectal cancer is greater than one primary lesion detected on initial presentation and occurs about 5% of the time.

This is a 78 year-old female with past medical history of left-sided breast cancer treated with neoadjuvant chemotherapy who presented with symptomatic anemia found to have a hemoglobin of five and positive fecal occult blood test. Patient was transfused and taken for EGD/colonoscopy, which showed three polypoid rectal lesions and three separate colon masses. Preliminary pathology showed high grade dysplasia in cecal mass and carcinoma in situ in rectal polyp. CT scan findings included 4.2 x 2.7 cm mass at cecum as well as areas of bowel wall thickening at proximal descending colon, proximal sigmoid colon, and distal rectosigmoid colon. Patient was taken to the operating room for rectal exam under anesthesia and laparoscopic subtotal colectomy. Post-operative pathology confirmed moderately-differentiated invasive adenocarcinoma arising from tubulovillous adenomas with lymph-vascular and perineural invasion. Five out of twelve lymph nodes sampled were involved.

This patient never had a colonoscopy but was recommended to get one two years prior when some areas of her colon were found to be prominent on PET scan, however she did not follow up. The importance of screening for colorectal cancer has never been more apparent than it is today with its proven benefit to decrease mortality.

Keywords

colorectal neoplasms, colonic neoplasms, multiple primary neoplasms, adenocarcinoma

Disciplines

Digestive System Diseases | Medicine and Health Sciences | Neoplasms

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May 3rd, 8:00 AM

A Case of Synchronous Colorectal Carcinoma Manifested as Three Separate Colon Masses

Colorectal cancer is the second leading cause of cancer-related deaths in the United States amongst cancers that affect both genders. Synchronous colorectal cancer is greater than one primary lesion detected on initial presentation and occurs about 5% of the time.

This is a 78 year-old female with past medical history of left-sided breast cancer treated with neoadjuvant chemotherapy who presented with symptomatic anemia found to have a hemoglobin of five and positive fecal occult blood test. Patient was transfused and taken for EGD/colonoscopy, which showed three polypoid rectal lesions and three separate colon masses. Preliminary pathology showed high grade dysplasia in cecal mass and carcinoma in situ in rectal polyp. CT scan findings included 4.2 x 2.7 cm mass at cecum as well as areas of bowel wall thickening at proximal descending colon, proximal sigmoid colon, and distal rectosigmoid colon. Patient was taken to the operating room for rectal exam under anesthesia and laparoscopic subtotal colectomy. Post-operative pathology confirmed moderately-differentiated invasive adenocarcinoma arising from tubulovillous adenomas with lymph-vascular and perineural invasion. Five out of twelve lymph nodes sampled were involved.

This patient never had a colonoscopy but was recommended to get one two years prior when some areas of her colon were found to be prominent on PET scan, however she did not follow up. The importance of screening for colorectal cancer has never been more apparent than it is today with its proven benefit to decrease mortality.

 

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