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Kas 7-9E: The patient with colorectal carcinoma
53 years old woman in good general condition admitted because of colicky pain. Ileus was
diagnosed and she underwent a surgery.
Family history: mother alive, father died at the age of 81 of MI, nil relevant from the point of
view of oncology.
Past medical history: patient has never been seriously ill, allergy to feathers, smokes 10
History of the present complaint: acute surgery because of ileus, hemicolectomy performed.
Oncological opinion requested.
Physical examination: on examination no abnormalities, scar after surgery.
Other examinations: FBC and biochemistry normal, Tumour marker: CEA: 36.4 ug/l,
CA19-9: 75.8. kU/l, Histology: well differentiated cylindrocellular carcinoma infiltrating
through the bowel wall up to serosis. Six lymph nodes identified, all histologically negative.
Grade I.
Questions and tasks:
What other staging examinations are necessary to establish the extent of the disease?
What are typical symptoms of colorectal cancer?
What is the most often metastatic site of colorectal cancer?
What is grading and its significance?
Is it further follow-up of this patient necessary after completion of primary
treatment? If yes, why, how often and which examinations are recommended?
6. What types of prevention do you know?
7. Differences between right and left side colon cancer. Precancerous conditions and
lesions of the colorectal cancer
8. Intestine motility disorders.