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Case #5

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Expand Physical Exam

Intermittent bouts of pain in the epigastric and mid-abdominal areas and unexplained weight loss. No epigastric or abdominal masses palpated. No hepatosplenomegaly. Cervical, axillary, and femoral lymph nodes are all normal.

Expand Imaging

10/12/XX

Chest x-ray: negative
Abdominal CT: No abnormalities seen.
Upper GI: No evidence of disease.

Expand Laboratory

10/13/XX

CEA: 8.0 (within normal limits)

Expand Scopes

10/20/XX

Esophagogastroduodenoscopy (EGD): Irregular 6 mm polyp in the 2nd to 3rd portion of duodenum, polypectomy done.

Expand Pathological Reports

10/20/XX

EGD biopsy: adenocarcinoma arising in a polyp

12/01/XX

Partial duodenal resection: very minute focus of residual adenocarcinoma confined to superficial lamina propria. No invasion into underlying muscle layer is seen.

Expand Treatment

10/20/XX

Surgery: Polypectomy

12/01/XX

Surgery: Partial duodenal resection