Rectal Cancer: Local Excision [sounds like]
9 results
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Malignancy- A 62-year-old woman presents to the office with a 1-month history of rectal pain, bleeding, and perianal mass. On digital rectal examination and anoscopy, a 3-cm firm mass is noted at the left lateral anal canal. Inguinal examination is unremarkable. Biopsy of the mass shows moderately differentiated squamous cell carcinoma. Staging computed tomography (CT) of the chest and abdomen and magnetic resonance imaging (MRI) of the pelvis demonstrate a T2N1M0 tumor. What is the best next step in her management?
- A 56-year-old obese man with locally advanced distal rectal cancer is treated with total neoadjuvant chemoradiation therapy. His is a 45-pack-per-year smoker. Restaging reveals no sign of metastasis. Magnetic resonance imaging (MRI) rectal protocol reveals partial clinical response and flexible sigmoidsociopy that shows a 3-cm tumor involving the sphincteric complex. What is the best surgical approach in his care?
- 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 61-year-old man is found to have a 2-cm mass in the mid-rectum (8 cm from the anal verge) on diagnostic colonoscopy. Biopsy reveals moderately differentiated adenocarcinoma. Computed tomography (CT) reveals no evidence of metastatic disease, and magnetic resonance imaging (MRI) demonstrates a cT3, node-negative cancer. After presentation at a multidisciplinary tumor board, the patient agrees to total neoadjuvant therapy. The patient has a complete clinical response to treatment and opts for close radiologic and endoscopic surveillance in an effort to avoid surgery. On a surveillance proctoscopy 6 months after treatment, the patient is found to have a 7-mm recurrence at the original cancer site. Which of the following is the best next step in management?
- A 45-year-old man undergoes a screening colonoscopy, which shows a 1.5-cm polyp in the rectum located 5 cm from the anal verge. Biopsy reveals well-differentiated invasive adenocarcinoma without lymphovascular invasion, perineural innovation, or tumor budding. Staging computed tomography (CT) does not show any evidence of metastatic disease, and his carcinoembryonic antigen (CEA) level is normal. Magnetic resonance imaging (MRI) of the pelvis reveals the polyp to be a T-1 lesion without any evidence of lymph node metastasis. What is the most appropriate next step in treatment?
- 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
- Which technical/surgical factor during proctectomy most influences the risk of local recurrence?
- A 50-year-old man presents with abdominal pain. Colonoscopy with biopsy revealed a large B cell lymphoma in the ascending colon. Staging workup reveals a nonobstructing mass in the ascending colon without evidence of metastatic or multifocal disease. The best next step is
- Anorectal Disease