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Moderately Differentiated Adenocarcinoma (Hereditary Nonpolyposis Colon Cancer)

Shogan PJS - MedPix (2008)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Moderately Differentiated Adenocarcinoma (Hereditary Nonpolyposis Colon Cancer)

History: 42 yo male with abdominal pain

Findings: Acute abdominal series demonstrates a normal PA chest radiograph without subdiaphragmatic free air. There are differential air fluid levels in the mid-abdomen, with dilated loops of small bowel. There is a paucity of bowel gas projecting over the rectum, and stool is noted in the RLQ. Contrast enhanced axial CT images through the abdomen demonstrate a bulky, irregular heterogeneous cecal mass with pericolic inflammation and asymmetric wall thickening. Multiple dilated fluid filled loops of small bowel are noted, some of which contain air fluid levels. Additionally, there is fecalization of the terminal ileum. The appendix is normal.

Ddx: Adenocarcinoma (Hereditary Nonpolyposis Colon Cancer) Lymphoma Metastasis Carcinoid Tumor GIST Diverticulitis Crohn’s Disease Typhlitis (Neutropenic Colitis) Ischemic Necrosis of the Cecum (rare – patients with a history of cardiac failure and arrhythmia). Reference: Hoeffel et al. RadioGraphics 2006;26:1373-1390.

Dxhow: The patient underwent an exploratory laparotomy and subsequent subtotal colectomy. Pathologic evaluation of the surgical specimen demonstrated a 10.1 cm moderately differentiated adenocarcinoma involving the cecum. 0/24 lymph nodes were positive for metastasis, the appendix and ileal mucosa were normal.

No MeSH data available.


Upright AP abdominal radiograph demonstrates differential air fluid levels in the mid-abdomen.  There is a paucity of bowel gas projecting over the rectum.  The small bowel is dilated.
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MPX1419_synpic43431: Upright AP abdominal radiograph demonstrates differential air fluid levels in the mid-abdomen. There is a paucity of bowel gas projecting over the rectum. The small bowel is dilated.


Moderately Differentiated Adenocarcinoma (Hereditary Nonpolyposis Colon Cancer)

Shogan PJS - MedPix (2008)

Upright AP abdominal radiograph demonstrates differential air fluid levels in the mid-abdomen.  There is a paucity of bowel gas projecting over the rectum.  The small bowel is dilated.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1419&req=5

MPX1419_synpic43431: Upright AP abdominal radiograph demonstrates differential air fluid levels in the mid-abdomen. There is a paucity of bowel gas projecting over the rectum. The small bowel is dilated.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Moderately Differentiated Adenocarcinoma (Hereditary Nonpolyposis Colon Cancer)

History: 42 yo male with abdominal pain

Findings: Acute abdominal series demonstrates a normal PA chest radiograph without subdiaphragmatic free air. There are differential air fluid levels in the mid-abdomen, with dilated loops of small bowel. There is a paucity of bowel gas projecting over the rectum, and stool is noted in the RLQ. Contrast enhanced axial CT images through the abdomen demonstrate a bulky, irregular heterogeneous cecal mass with pericolic inflammation and asymmetric wall thickening. Multiple dilated fluid filled loops of small bowel are noted, some of which contain air fluid levels. Additionally, there is fecalization of the terminal ileum. The appendix is normal.

Ddx: Adenocarcinoma (Hereditary Nonpolyposis Colon Cancer) Lymphoma Metastasis Carcinoid Tumor GIST Diverticulitis Crohn’s Disease Typhlitis (Neutropenic Colitis) Ischemic Necrosis of the Cecum (rare – patients with a history of cardiac failure and arrhythmia). Reference: Hoeffel et al. RadioGraphics 2006;26:1373-1390.

Dxhow: The patient underwent an exploratory laparotomy and subsequent subtotal colectomy. Pathologic evaluation of the surgical specimen demonstrated a 10.1 cm moderately differentiated adenocarcinoma involving the cecum. 0/24 lymph nodes were positive for metastasis, the appendix and ileal mucosa were normal.

No MeSH data available.