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Colorectal adenocarcinoma with mets to liver

USU Teaching File MUTF - MedPix

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Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Colorectal adenocarcinoma with mets to liver

History: 51 y/o presented to ER with 3 mo Hx steadily decreasing stool caliber and vague, diffuse, intermittent abdominal pain coinciding with episodic BRBPR. Also c/o worsening fatigue and DOE with 1 flight of stairs x 2 weeks. Denies F/C/N/V/CP/melena. Seen at Clinic the day prior to presentation and was treated with colace. CBC later revealed h/h of 6.6 and 20.6. Reapeat h/h this am was 5.8/19.1. Pap and Mammo UTD, no Hx of similar Sx. Has never had any colon screening. Fam Hx. Significant for maternal Colon CA @ 60 y/o.

Findings: BE 03 Mar: Large, round, radiolucent obstruction in lower sigmoid colon with proximal dilation CT lungs 04 Mar: 100-15 cc pleural effusions bilaterially with associated rims of atelectasis CT abdomen 04 Mar: 12 small (<1 cm) lucencies throughout liver parenchyma; dilated, fluid filled GB without calcifications or evidence of obstruction CT pelvis 04 Mar 03: 30 mm irregular mass sigmoid colon, extending through mucosa and invading surrounding tissues; no evidence of lymph node enlargement

Ddx: Colon findings: Carcinoma, foreign body, diverticulitis, colonic rupture Liver findings: Metastatic disease, hemangiomas, cystsLung findings: Anemia, inflammatory changes

Exam: Vitals: BP 114/60 P 94 T 99.0 RR 18 Ht 160 cm Wt 63 kg Pertinent Physical findings: General: Pale, tired, NADEyes: pale sclera Lungs: CTA Bilat no W/R/R Abd: Soft, minimal diffuse TTP, no rebound, no guarding, normal BS, no hepatosplenomegalyLabs:6.3>5.1/17<503 mcv 68 rdw 16.6138/4/1/103/22/13/0.7/96 ca 8.6 UA: Neg

No MeSH data available.


CT pelvis 04 Mar 03:  30 mm irregular mass sigmoid colon, extending through mucosa and invading surrounding tissues; no evidence of lymph node enlargement
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MPX2202_synpic15257: CT pelvis 04 Mar 03: 30 mm irregular mass sigmoid colon, extending through mucosa and invading surrounding tissues; no evidence of lymph node enlargement


Colorectal adenocarcinoma with mets to liver

USU Teaching File MUTF - MedPix

CT pelvis 04 Mar 03:  30 mm irregular mass sigmoid colon, extending through mucosa and invading surrounding tissues; no evidence of lymph node enlargement
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2202&req=5

MPX2202_synpic15257: CT pelvis 04 Mar 03: 30 mm irregular mass sigmoid colon, extending through mucosa and invading surrounding tissues; no evidence of lymph node enlargement

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Colorectal adenocarcinoma with mets to liver

History: 51 y/o presented to ER with 3 mo Hx steadily decreasing stool caliber and vague, diffuse, intermittent abdominal pain coinciding with episodic BRBPR. Also c/o worsening fatigue and DOE with 1 flight of stairs x 2 weeks. Denies F/C/N/V/CP/melena. Seen at Clinic the day prior to presentation and was treated with colace. CBC later revealed h/h of 6.6 and 20.6. Reapeat h/h this am was 5.8/19.1. Pap and Mammo UTD, no Hx of similar Sx. Has never had any colon screening. Fam Hx. Significant for maternal Colon CA @ 60 y/o.

Findings: BE 03 Mar: Large, round, radiolucent obstruction in lower sigmoid colon with proximal dilation CT lungs 04 Mar: 100-15 cc pleural effusions bilaterially with associated rims of atelectasis CT abdomen 04 Mar: 12 small (<1 cm) lucencies throughout liver parenchyma; dilated, fluid filled GB without calcifications or evidence of obstruction CT pelvis 04 Mar 03: 30 mm irregular mass sigmoid colon, extending through mucosa and invading surrounding tissues; no evidence of lymph node enlargement

Ddx: Colon findings: Carcinoma, foreign body, diverticulitis, colonic rupture Liver findings: Metastatic disease, hemangiomas, cystsLung findings: Anemia, inflammatory changes

Exam: Vitals: BP 114/60 P 94 T 99.0 RR 18 Ht 160 cm Wt 63 kg Pertinent Physical findings: General: Pale, tired, NADEyes: pale sclera Lungs: CTA Bilat no W/R/R Abd: Soft, minimal diffuse TTP, no rebound, no guarding, normal BS, no hepatosplenomegalyLabs:6.3>5.1/17<503 mcv 68 rdw 16.6138/4/1/103/22/13/0.7/96 ca 8.6 UA: Neg

No MeSH data available.