פורום סרטן מערכת העיכול - מעי גס, לבלב, קיבה, דרכי מרה

אבא שלי ישראלי שמתגורר בארה"ב. לפני פחות מחודש נותח באופן דחוף להוצאת גידול מהמעי הגס לאחר בדיקת קלונוסקופיה. הופנה בגלל גילוי גרורות בכבד. הוא מתכוון דחוף להגיע לארץ להמשך טיפול. השאלה שלי, למה אפשר לקוות במידה והנתונים כדלקמן: 

אולטראסאונד כבד: 

There are multiple solid masses in the liver. The largest involves the right hepatic lobe measures 3.9x2.9x3.6 cm

בדיקת CT: 

The liver demonstrates multiple lesions too numerous to count throughout left and right lobes of the liver. Gallblader demonstrates multiple gallstones

ביופסיה:

Left liver lobe biopsy 

Metastatic colorectal carcinoma

Metastatic carcinoma is present in 5 of 12 pericolic lymph nodes

A specimen is received fresh and consists of a wedge of pink-tan liver that measures 2.3x1.8x1.3cm. On sectioning there is a grey-white gritty mass that measures 1.3x1.0cm. Specimen is submitted in its entirety as A1 and A2. 

Portion of left colon

The specimen is received fresh and consists of segment of colon that measures 35.6 cm in length and ranges from 2.9 to 8.7 cm in circumference. Located 3.0 cm from one surgical margin is a circumferential, pink-tan, ulcerated lesion that measures 4.7x3.7x1.3 c. This mass strongly extends through the muscle wall and into the surrounding fat. The lesion comes to within 7.1 cm of the vascular pedicle margin. On examination the remaining mucosa is grossly unremarkable. Examination of the pericolic mesentery shows sixteen probable lymph nodes. Representative sections are submitted as B1 surgical margin, surgical margin nearest tumor inked, B2-B4 sections of tumor, B5 vascular pedicle margin, B6 three probable lymph nodes in their entirety - one bisected, B7 four probable lymph nodes in their entirety, B8 - four possible lymph nodes in the entirety, B9 - four probably lymph nodes in their entirety, B10 - LArgest lymph node bisected.

Microscopic comment:

Sections confirm liver involved by a circumscribed and extensively necrotic tumor consisting of small malignant glands possessing oval nuclei, frequent small nucleoli and basophilic cytoplasm. The center of the lesions shows "dirty" necrosis. The tumor is strongly positive for CDX2 by the immunoperoxidase technique. The overall findings are consistent with a diagnosis of metastatic colorectal carcinoma.

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