Colon

Question 1

High risk feature of colon cancer

Answer 1

High-risk factors for recurrence (exclusive of those cancers that are MSI-H):
*poorly differentiated/undifferentiated histology;
*lymphatic/vascular invasion;
*bowel obstruction
*; <12 lymph nodes examined;
*perineural invasion (PNI);
*localized perforation;
*close, indeterminate, positive margins; or
*high-tier tumor budding.

Question 2

Left sided colon cancer presents with

Answer 2

Left sided tumor-
o Change in bowel habit
o Constipation alternating with diarrhea (increase use of laxative) o Morning diarrhea- mixed mucus and or blood
o Abdominal pain
o Obstructive symptoms–nausea and vomiting.
o PRbleeding.
o Decrease in stool caliber.

Question 3

Right sided colon cancer presents with

Answer 3

Right-sided tumor-
o Oftenasymptomatic
o Dull,ill-definedabdominalpain
o Symptomatic anemia (weakness, fatigue, weight loss) o Right sided abdominal mass
o Melena
o Sacral pain or sciatic pain
- Patients with rectal cancer may present with a change in bowel movements; rectal fullness, urgency, or bleeding and tenesmus

Question 4

D/d of raised CEA

Answer 4

D/D of raised CEA- malignant-Ca of stomach, pancreas, lung, breast, medullary thyroid Benign- IBD, cirrhosis, pancreatitis, hypothyroidism, heavy smoker

Question 5

Survival for colonic carcinoma

Answer 5

Stage I 80%
Stage II 60%
Stage III 25%