A 53- year- old woman with long standing ulcerative colitis, presented to her GP with a 5 -month history of weakness & fatigue. She also reported a weight loss of 16lbs over the time period. Her physical examination was unremarkable; her abdomen was soft and non-tender with no hepatosplenomegaly. Rectal exam did not reveal any masses or haemorrhoids.
Her laboratory findings were:WBC 5200 cells/mm3(4500-11000); Hb 7.5 g/dL(13.5-17.5);Hct 26%(35-48);RBC count 3.5 x 106 cells/mm3(4-6);platelet count 650000 cells per mm3(150000-450000); MCV 55mm3(80-100); reticulocyte count 1.5%(0.5-1.5); urea 15 mg/dL(7-21); creatinine 1.1 mg/dL(0.6-1.1) ;total bilirubin 0.9 umol/dL(0.5-2.5); total calcium 9.2 mg/dL(8-10) Ferritin 8 ng/ml(12-150);CEA 6 ng/ml( < 3 ng/ml).
Abdominal ultrasound was normal. Colonoscopy revealed a mass approx. 6 cm in the ascending colon. A biopsy was taken and histology revealed a poorly differentiated adenocarcinoma. Abdominal CT showed an apple-core lesion in the same area as seen by colonoscopy. No liver lesions were found. Chest CT was unremarkable.
2 units of packed red cells were given and once the Hct reached 38% a right hemicolectomy was performed. Pathology of specimen confirmed adenocarcinoma invading through the muscularispropria into the pericolic fat. 4/21 pericolic lymph nodes were found to be positive for metastatic carcinoma. The cancer was staged as T3N2M0 or Stage lllC. The post op CEA was 0.2 ng/dL.
The patient was subsequently referred to oncology for chemotherapy
For a custom-written answer, place your order now!
What We Offer
• On-time delivery guarantee
• PhD-level professional writers
• Automatic plagiarism check
• 100% Privacy and Confidentiality
• High Quality custom-written papers
