Indications for Neoadjuvant Therapy
8 results
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Malignancy- A 34-year-old patient presents with vague pelvic discomfort. Digital rectal examination (DRE) reveals a 3-cm anterior soft, compressible lesion that is 4 cm from the anal verge. Pelvic magnetic resonance imaging (MRI) shows a presacral solid mass that measures 2.5 cm x 2 cm with its most proximal part at S3 level. There is a clear plane between the lesion and the rectum anteriorly and the sacrum posteriorly. What is the best next step in treatment of this patient?
- A 70-year-old woman with a medical history of hypertension and hypothyroidism reports rectal bleeding, maroon blood mixed in with her stool, and weight loss to her primary care physician. She is referred to undergo diagnostic colonoscopy. She is found to have a hepatic flexure mass with biopsies taken and tattoo placed distally, with pathology returning as moderately differentiated adenocarcinoma, mismatch repair (MMR) protein expression intact. Laboratory testing includes a complete blood count, basic chemistry, and carcinoembyronic antigen (CEA) with findings of anemia and a mildly elevated CEA level. What imaging is recommended for completion of the staging work-up in this patient?
- A healthy 65-year-old male patient is diagnosed with a moderately differentiated rectal adenocarcinoma, microsatellite stable. Staging was negative for metastatic disease. Pelvic magnetic resonance imaging (MRI) shows possible involvement of the prostate with mesorectal lymph nodes suspicious for metastasis. What is the current recommended course of treatment for this patient, given these findings?
- A 48-year-old man with T3N1 rectal adenocarcinoma is treated with total neoadjuvant therapy. He undergoes repeat clinical staging with computed tomography (CT) of his chest, abdomen, and pelvis, and magnetic resonance imaging (MRI) of his pelvis. He is found to have flexible sigmoidoscopy revealing a complete clinical response. Which of the following is an accurate prognosis?
- A 57-year-old man undergoes total neoadjuvant therapy (TNT) for management of a cT3N1M0 rectal cancer. After completion of both chemotherapy/radiotherapy and consolidation chemotherapy, the presence of complete clinical response to treatment is assessed by
- A healthy 47-year-old patient undergoes a laparoscopic sigmoidectomy with a primary colorectal anastomosis for the diagnosis of colon cancer. Pathology reveals a pT3N2Mx malignancy that is mismatch repair (MMR) stable. The best next step in the management of this patient is
- A 65-year-old man undergoes screening colonoscopy. A 1-cm submucosal mass is seen in the mid rectum. Biopsy results show spindle cells with KIT (CD117) positivity with a low mitotic rate. Complete staging is performed without any evidence of metastatic or locally advanced tumor. What is the most appropriate management?
- Benign Disease