Adeno Carcinoma - Rectum

CASE NO 1

NAME- DR.K.T.,AGE-33

ADENO –CARCINOMA- RECTUM GR- I

HISTORY

A male patient of age 33 yrs doctor by profession diagnosed as- Adenocarcinoma rectum gr.I on 9/05/06, consulted on 16/06/2006 With c/o-

  • Blood mixed stools,
  • Pain p/r,
  • Fatigue ++++,
  • Pain legs,
  • Significant weight loss,
  • Low appetite
  • Fullness abdomen,
  • Gurgling sounds abdomen++++,
  • Flatulence++++,
  • Occasional constipation,
  • Urticaria++,
  • Sleeplessness,
  • Breathlessness,

O/E findings

R.S.-air entry bilaterally equal, no added sounds heard

CVS – murmur (anemic),

CNS- NAD

P/A- tender on palpation lt...iliac, inguinal +++

Radiological findings--

C.T.Scan - 20/6/06 -

Polypoidal soft tissue mass seen in rectum of size 4.6*5 cms rectal opening almost compressed due to the mass.

After 15 days --- much symptomatic relief-

pain p/r reduced , fatigue much better, pain legs decreased ,appetite improved , Fullness abdomen reduced ,constipation decreased, Sleep improved , breathlessness reduced ,

Follow up scan after 5 months-

Polypoidal soft tissue mass seen in rectum measuring in size 3.3*2.2 Cms shows minimal reduction in size , rectal opening slightly widened

After 1 yr of fallow up scan

Polypoidal soft tissue mass seen in rectum measuring in size 4.2*2.3 Cms. shows minimal increase in size, rectal opening seen clearly

After 6 months of follow up scan

After 6 months of follow up scan dated 2/04/08 Polypoidal soft tissue mass seen in rectum measuring in size 2.6 Cms shows significant reduction in size, rectal opening widened

On 27/08/08

Polypoidal soft tissue mass seen in rectum measuring in size 2.7 cms shows no significant change in size, rectal opening seen clearly

SIGNIFICANT WT GAIN BY 5 KGS ONE OF THE INDICATIONS OF ARREST MALIGNANT PROCESS

WT CHRT

QOL( Quality of life questionnaire) CHART

ACHIEVEMENTS

Quality of life score – Normal, no functional disability during the treatment, Kernoffsky’s score excellent, asymptomatic patient in spite of almost 4 yrs. Of malignancy, indicating arrest of cancerous process, significant wt gain indicating excellent absorption and metabolism, no signs of GI upset, significant regression of mass to almost half the size, no further metastasis indicating arrest of cancerous process, no further complications expected or otherwise.


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