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...A 26-year-old woman presents with colon cancer. How do you assess the possibility of genetically inherited colon cancer? Diagnostic criteria (eg, Amsterdam, Bethesda) can be used to identify individuals with HNPCC....
Last Updated March 17, 2023
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...A 45-year-old man is referred to you by his gastroenterologist after he is found to have a 3-cm serrated adenoma in the ascending colon. How would you evaluate this patient? Understand the significance of serrated polyp histology to possible hereditary colorectal cancer syndrome....
Last Updated August 15, 2023
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Operative Standards for Cancer Surgery: Volume 1 > Chapter 16. Colon Resection
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...Epidemiology Be able to recognize a potential genetic predisposition to colorectal cancer in a patient, even if most colon polyps are sporadic.
Familial adenomatous polyposis (FAP):
Hundreds to thousands of carpeting adenomatous polyps by the early 20s
If FAP is attenuated...
Last Updated March 17, 2023
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from Operative Standards for Cancer Surgery: Volume 1
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... patient with a malignant large bowel obstruction undergoes urgent surgical resection: high ligation of the vascular pedicle to obtain an adequate lymph node harvest and 5-cm proximal and distal margins.
In the case of obstructing colon cancer in which an R0 oncologic operation is not feasible...
Last Updated December 5, 2023
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Operative Standards for Cancer Surgery: Volume 1 > Chapter 16. Colon Resection
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...A 32-year-old man is referred to your clinic by his primary care provider for a 6-month history of constipation and intermittent blood-streaked stool on toilet paper after wiping. He states he is concerned about colon cancer because his 58-year-old father was recently diagnosed with rectal cancer...
Last Updated March 17, 2023
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...A 49-year-old man presents with findings concerning for an ACC on an abdominal CT performed during a workup for chronic abdominal pain. What are your next steps in evaluating and treating this patient? Appropriately stage the cancer and describe what additional imaging is recommended. ...
Last Updated July 8, 2024
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...A 52-year-old obese man was diagnosed with a sigmoid colon cancer. He underwent CT scans that demonstrated no evidence of distant disease. The patient desires a minimally invasive surgery. Discuss your operative approach. Anticipate technical challenges associated with the use of laparoscopic...
Last Updated August 15, 2023
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... operating room and creation of an end ileostomy with mucous fistula. Four weeks after discharge, he has almost completely recovered but is still undergoing physical therapy. What are your treatment recommendations? Accurately stage this patient's colon cancer....
Last Updated March 18, 2023
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...A patient is in clinic with an AAA unamenable to an endovascular approach. He has a history of prior transverse abdominal colectomy for colon cancer. What would be the best approach to repair, and how should this patient be counseled preoperatively? Include preoperative imaging findings suggestive...
Last Updated August 16, 2023
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...A 51-year-old woman presents to your clinic with complaints of anal bleeding and pain. Physical examination reveals a 3-cm ulcerated anal lesion. What is your approach in evaluating this patient further? Be able to provide a differential diagnosis for ulcerated anal lesions (eg, cancer, infection...
Last Updated November 1, 2023
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... used.
On the right, the liver is retracted, the hepatic flexure of the colon is taken down, and the duodenum is kocherized to expose the right adrenal gland.
On the left, the splenic flexure of the colon is taken down, the gastrocolic ligament is divided, and the splenorenal ligament is...
Last Updated September 1, 2021
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...A 35-year-old patient has recently tested positive for a mutation on the APC gene when she presented for resection of her colon cancer. She has a child who is 12 years old. What are your recommendations regarding genetic workup for her child? What are your recommendations for colorectal cancer (CRC...
Last Updated August 15, 2023
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Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 21e > Chapter 52. Colon and Rectum
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...Diagnosis Physical Findings
In a patient with rectal cancer, be able to describe the key elements of a physical exam.
Digital rectal exam (DRE) is essential to assess height, involvement of the anal sphincter, and relationship to the levator ani.
It is important to note mobility, adherence...
Last Updated August 15, 2023
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...-adenocarcinoma sequence similar to colon cancer with similar genetics, including frequent mutations in K-ras and p53.
...
Last Updated August 14, 2023
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..., macrocephaly, breast cancer, endometrial cancer, non-medullary thyroid cancer, colon cancer, renal cell cancer
STK11/LKB1
(Peutz-Jeghers syndrome)
<1%
55%
Hamartomatous gastrointestinal tract polyps; characteristic...
Last Updated January 1, 0001
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Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 21e > Chapter 52. Colon and Rectum
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...A 65-year-old patient is found to have a GEJ adenocarcinoma. PET/CT shows no evidence of distant metastatic disease. EUS demonstrates that this is a uT2N0 cancer. What is the next step in management? Describe the current indications for neoadjuvant CRT for esophageal carcinoma....
Last Updated April 24, 2024
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....
Unlike other solid tumors with clearly-defined biomarkers (CA 19-9, CEA, CA-125, PSA) and with specific patterns of distant metastasis (ie, lung for colon cancer, lung for sarcoma), breast cancer is typically surveilled with:
Clinical breast exam
Basic laboratory tests...
Last Updated December 1, 2023
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Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 21e > Chapter 13. Surgery in the Geriatric Patient
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Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 21e > Chapter 52. Colon and Rectum
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Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 21e > Chapter 52. Colon and Rectum