Summary Staging 2000 Exercises, Case 1 Notes

Physical Exam

03/20/2001

Four day history of blood in stool; Rectal exam: Within Normal Limits; Abd: Tender upper outer quadrant, no HSM, no LAD appreciated.

X-Rays and Scans

03/20/2001

CXR: Normal

CT Abdomen: Approx. 2.5 cm mass in the colon at approx. the splenic flexure, does not extend into peritoneum; no HSM evident; no LAD.

Scopes

03/27/2001

Colonoscopy w/biopsy: Fungating tumor mass at 85 cm (splenic flexure), obvious adenocarcinoma, resection is warranted.

Laboratory

03/27/2001

LFTs: Normal

Operative Findings

03/27/2001

Transverse and descending colon resection with anastomosis and regional LN dissection: Mass confined to colon; no HSM; 12 regional LNs removed.

Pathology Reports

04/06/2001

Colonoscopic biopsy: Adenocarcinoma

04/06/2001

Gross: Transverse colon, descending colon, 12 regional LNs

Micro: Mod diff colonic adenocarcinoma, 2.2 cm in size, extending through muscularis propria, into the serosa; all 12 LNs free of disease.

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