Gastric Outlet Obstruction as an Initial Presentation of Stage IV Colon Cancer Successfully Treated with Only Surgery with 4 Year Survival- A Case Study
T. Gavrancic
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai /James J. Peters VA Medical Center, NY, Bronx, USA.
V. Jain
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai /James J. Peters VA Medical Center, NY, Bronx, USA.
D. Sharma
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai /James J. Peters VA Medical Center, NY, Bronx, USA.
K. Simeunovic *
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai /James J. Peters VA Medical Center, NY, Bronx, USA.
Ava Anklesaria
Gastroenterology Department, Icahn School of Medicine at Mount Sinai /James J. Peters VA Medical Center, NY, Bronx, USA.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Gastric outlet obstruction (GOO) is an unusual initial presentation of locally advanced colorectal cancer (CRC).
Case Description: A 76-year-old male presented with nausea, vomiting, and weight loss. Physical exam was remarkable for cachexia and epigastric tenderness. Blood analysis was remarkable for microcytic anemia. CT scan of abdomen revealed a soft tissue mass surrounding the pylorus of the stomach and a concentric mass-like thickening in the transverse colon with lymphadenopathy. Colonoscopy revealed a partially obstructive and fungating mass in the transverse colon. Biopsy confirmed invasive adenocarcinoma. The patient underwent extensive surgery. However, due to a poor performance status, he did not receive adjuvant chemotherapy. He continues to survive 4 years post-surgery, without any evidence of recurrence.
Conclusion: Surgical resection of locally advanced stage IV CRC causing acute GOO in the patient with poor performance status can lead to prolonged disease free survival in individual cases after curative surgery, even without adjuvant chemotherapy.
Keywords: Colon cancer, GOO, survival, locally advanced colon cancer; surgery.