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Colorectal Cancer Case Studies

Case Studies: Surgically Unresectable Metastatic Colorectal Cancer

In this case-based interview, Edward Chu, MD, discusses the diagnosis and treatment of patients with metastatic colorectal cancer.

Surgically Unresectable Metastatic Colorectal Cancer Case: 2

  • A 47-year-old male presented to the doctor with abdominal pain and anemia
  • He has a family history of cancer:
    • His brother was diagnosed with colon cancer at age 44
    • His sister was diagnosed with gastric cancer at age 24, and mother was diagnosed with endometrial cancer at age 50
    • He has 2 children, a 15-year old boy and a 10-year old girl
  • Initial lab evaluations showed anemia (Hb 8.0 g/dL) and elevated carcinoembryonic antigen (980 ng/ml)
  • CT-scan showed a large mass in the ascending colon and diffuse liver nodules
  • Biopsy results showed a moderately differentiated adenocarcinoma
    • Microsatellite instability (MSI) testing revealed MSI-high (MSI-H) tumor and IHC confirmed the absence of expression of the MLH1 protein
    • He was referred for genetic testing
  • The patient was diagnosed with hereditary nonpolyposis colorectal cancer syndrome
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