Rectal Cancer Spreading to the Thyroid and Bones

This colorectal cancer diagnosis at a glance

Subtype
Adenocarcinoma
Biomarkers
CEA 2.75 ng/mL at diagnosis
Sex
Male
Spread to
thyroid|bones
Treatment
surgery, chemotherapy, radiation, targeted therapy and palliative care
Outcome
In Memory

Treatment course, step by step

  1. He received a colostomy, chemoradiation, rectal surgery, and 6 postoperative chemotherapy cycles.
  2. A thyroid metastasis was surgically reduced, followed by further chemotherapy.
  3. After bone progression, he had hip surgery and 3 cycles of bevacizumab and capecitabine before choosing supportive care.

What happened, in summary

A 46-year-old man presented with 3 months of rectal bleeding and weight loss. Colonoscopy found a rectal mass 4 cm from the anal verge, and biopsy showed moderately differentiated adenocarcinoma. Initial metastatic testing was negative and CEA was 2.75 ng/mL.

He underwent a diverting colostomy, then long-course radiation with 5-fluorouracil and folinic acid. Two months later, he had anterior resection with total mesorectal excision. The rectal cancer involved the full bowel wall, but margins and all 8 sampled lymph nodes were negative. He then completed 6 adjuvant chemotherapy cycles.

A rapidly enlarging thyroid mass later caused severe breathing difficulty. Total thyroid surgery and debulking showed metastatic colorectal adenocarcinoma. He received irinotecan, folinic acid, and 5-fluorouracil. After a pathological fracture of the left femoral neck revealed multiple bone metastases, he underwent partial hip replacement and switched to bevacizumab with capecitabine. His condition worsened after 3 cycles. He declined further treatment, chose supportive care, and died at home within 2 months.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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