We performed your procedure due to an indication of:
Colonic mass - K63.89
Elevated CEA: 795.81 - R97.0
Hematochezia: 578.1 -K92.1
Protruding Lesions
A large fungating mass of malignant appearance was found in the rectosigmoid junction at 10 cm from the anus.
The mass caused a complete obstruction. The scope could not traverse the lesion and the exam could not be finished. Cold forceps biopsies were performed. 4mL of SPOT ink injections were successfully applied for tattooing at 2 opposite walls just distal to the mass. Medium grade/stage lI internal hemorrhoids were noted.
============ CT results: ============
FINDINGS:
CHEST:
Thyroid gland: Homogenous.
Lymphadenopathy: None. Calcified mediastinal and hilar nodes related to old granulomatous disease. Heart: Normal in size.
Aorta and pulmonary artery trunk: Dilated pulmonary artery trunk measuring up to 4.4 cm suggestive of underlying pulmonary artery hypertension. Ascending thoracic aorta is also aneurysmal measuring up to 5.2 cm. Aortic arch and descending thoracic aorta are normal in diameter. No aortic dissection or central or segmental pulmonary embolism.
Tracheobronchial tree: Patent.
Lungs and pleural: Large 5x4 cm right upper lobe calcified granulomas with associated pulmonary distortion. Scattered smaller calcified granulomas are also present. There are several bilateral pulmonary micronodules measuring up to 5 mm in the left lower lobe.
ABDOMEN & PELVIS: Liver: Unremarkable.
Gallbladder: Cholecystectomy.
Pancreas: Unremarkable.
Spleen: Unremarkable.
Adrenal Glands: Unremarkable.
Kidneys and ureters: No nephrolithiasis or hydroureteronephrosis.
Bladder: Unremarkable.
Gastrointestinal tract: Long segment circumferential thickening of the rectosigmoid consistent with malignancy. This is insuperable from posterior uterine serosa. There is nodal metastasis to the sigmoid mesocolon nodes which measure up to 1cm.
Reproductive organs: Fibroid uterus. No adnexal mass. Aorta: Atherosclerotic changes without aneurysmal dilatation.
Lymphadenopathy: No retroperitoneal lymphadenopathy.
Bones: Multilevel degenerative changes. No acute fracture or suspicious lesions. Extraabdominal soft tissues: Unremarkable.
Unless otherwise recommended, any incidental findings identified above require no follow up imaging based on consensus recommendations. Fleischner 2017 criteria utilized when applicable for pulmonary nodule follow-up.
IMPRESSION:
1 Long segment circumferential thickening of the rectosigmoid consistent with malignancy. This is inseparable from posterior uterine serosa. There is nodal metastasis to the sigmoid mesocolon nodes which measure up to 1cm. No liver metastasis or retroperitoneal nodal metastasis.
2. Several bilateral pulmonary micronodules are present and could be related to metastasis or benign.
“There's some genetics testing done on the tissue but if the oncologist wants to perform additional genetic testing, it's done through blood or saliva testing”
家母(78岁)CT结果显示有Colon Cancer，因为也怀疑有淋巴和肺部转移，家庭医生安排了PET-Tumor-Total Body。如果已经转移到淋巴和肺部的话，一般不建议手术。家母比较抵抗外科手术。
肠镜医生建议先看肿瘤医生，PET可以延后，听肿瘤医生安排，因为肺部结果可能是年轻时肺结核遗留的。
到底应该先做PET-Tumor-Total Body还是先看肿瘤医生？
多谢！
============
Conlonnoscopy results:
============
We performed your procedure due to an indication of:
Colonic mass - K63.89
Elevated CEA: 795.81 - R97.0
Hematochezia: 578.1 -K92.1
Protruding Lesions
A large fungating mass of malignant appearance was found in the rectosigmoid junction at 10 cm from the anus.
The mass caused a complete obstruction. The scope could not traverse the lesion and the exam could not be finished. Cold forceps biopsies were performed. 4mL of SPOT ink injections were successfully applied for tattooing at 2 opposite walls just distal to the mass. Medium grade/stage lI internal hemorrhoids were noted.
============ CT results: ============FINDINGS:
CHEST:
Thyroid gland: Homogenous.
Lymphadenopathy: None. Calcified mediastinal and hilar nodes related to old granulomatous disease. Heart: Normal in size.
Aorta and pulmonary artery trunk: Dilated pulmonary artery trunk measuring up to 4.4 cm suggestive of underlying pulmonary artery hypertension. Ascending thoracic aorta is also aneurysmal measuring up to 5.2 cm. Aortic arch and descending thoracic aorta are normal in diameter. No aortic dissection or central or segmental pulmonary embolism.
Tracheobronchial tree: Patent.
Lungs and pleural: Large 5x4 cm right upper lobe calcified granulomas with associated pulmonary distortion. Scattered smaller calcified granulomas are also present. There are several bilateral pulmonary micronodules measuring up to 5 mm in the left lower lobe.
ABDOMEN & PELVIS: Liver: Unremarkable.
Gallbladder: Cholecystectomy.
Pancreas: Unremarkable.
Spleen: Unremarkable.
Adrenal Glands: Unremarkable.
Kidneys and ureters: No nephrolithiasis or hydroureteronephrosis.
Bladder: Unremarkable.
Gastrointestinal tract: Long segment circumferential thickening of the rectosigmoid consistent with malignancy. This is insuperable from posterior uterine serosa. There is nodal metastasis to the sigmoid mesocolon nodes which measure up to 1cm.
Reproductive organs: Fibroid uterus. No adnexal mass. Aorta: Atherosclerotic changes without aneurysmal dilatation.
Lymphadenopathy: No retroperitoneal lymphadenopathy.
Bones: Multilevel degenerative changes. No acute fracture or suspicious lesions. Extraabdominal soft tissues: Unremarkable.
Unless otherwise recommended, any incidental findings identified above require no follow up imaging based on consensus recommendations. Fleischner 2017 criteria utilized when applicable for pulmonary nodule follow-up.
IMPRESSION:
1 Long segment circumferential thickening of the rectosigmoid consistent with malignancy. This is inseparable from posterior uterine serosa. There is nodal metastasis to the sigmoid mesocolon nodes which measure up to 1cm. No liver metastasis or retroperitoneal nodal metastasis.
2. Several bilateral pulmonary micronodules are present and could be related to metastasis or benign.
检测。还是需要另外单独安排基因检测？
https://www.medsci.cn/article/show_article.do?id=5546e280142e
https://www.shanwei.gov.cn/swkjj/yaowen/kjdt/content/post_828204.html
！
这种情况，美国会立刻看专科和肿瘤科大夫的
“There's some genetics testing done on the tissue but if the oncologist wants to perform additional genetic testing, it's done through blood or saliva testing”
知道有些肿瘤癌症专科医院，即便你家医给做了PET，到肿瘤医生那还得再做一次PET，毕竟治疗还得靠癌症专科医生。这结肠肿瘤已够大的，现在连肠镜头都难以穿过了，想不出这不做手术还能有何办法，难不成非等完全肠梗阻再紧急手术吗？
这位权威退休后被返聘到和睦家医院。他说，在这种情况下，建议服用鸦胆子油胶囊试试，因为他亲见有的无望康复的病人服用后奇迹痊愈。他说，70-80%的人无效，但其余的人显效，按照循证医学标准无效，但不妨一试。资深西医推荐一种植物药让我有些吃惊。后因我兄长坚决反对任何中药/植物药而没有采取医生的建议。
不久前一位患口腔癌的高龄老人无法手术，医生说她恐怕只有几个月的寿命了，我和本坛网友欲千北商量，推荐她外用+内服这种胶囊，两个月后她感染新冠，新冠好了以后医生惊奇地发现癌已经缩小，最近一次检查发现癌肿进一步缩小到原来的五分之一。已经完全无碍了。不知道是这种植物药有效还是新冠病毒杀掉了癌细胞或者两者巧合同时起了作用。
你自己可以查查鸦胆子油+癌症。
我不知道在美国能否买到这种胶囊。
仅供参考。
疗。PET- CT可以提供更多远处转移的信息，但不要专门等PET- CT。这个病人需要手术（如果整体状况容许，病人愿意接受的话），根治性手术或姑息性手术（单纯造瘘手术）。这个病人随时可能发展为急性完全性肠梗阻，到那时只能急症手术造瘘，而急症手术的死亡率要远高于术前准备完善的结肠手术。再有这个肿物已经累积到子宫直肠窝了，很难做常规的直肠/乙状结肠切除，有可能需要做Pelvic exenteration手术。
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