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Colorectal Cancer Case Studies

Case Studies: Case Presentation in Advanced Colon Cancer

In this case-based interview, Michael Morse, MD, FACP, discusses management of two patients, one with quadruple wild-type unresectable metastatic colon cancer and another with locally advanced disease.

Case Presentation in Advanced Colon Cancer Case: 2

  • A 55-year old Caucasian male was admitted to the hospital with severe crampy right lower quadrant pain
    • He had a 2-month history of constipation, general abdominal discomfort, and tiredness
    • PMH remarkable for hyperlipidemia managed with diet and statin therapy
  • Laboratory findings remarkable for grade 2 anemia (Hb, 9.0 g/dL) and elevated CEA (6.7 ng/mL)
  • CT showed a non-obstructive mass in the sigmoid colon that infiltrated the full thickness of the bowel wall and involved adipose tissue
  • Biopsy results indicated poorly differentiated invasive adenocarcinoma
  • He opted for sigmoid colectomy and was referred to a surgeon
    • Following surgery, R0 resection with clear margins
    • 9 of 13 lymph nodes sampled were positive for adenocarcinoma
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