Lump
Posted: Mon Mar 20, 2017 1:37 pm
My mother(78 years old ) has stage 4 colon cancer. ( below is the finds after surgery )
Her treatment plan is Chemo (oxaliplatin) by port once every two weeks and xeloda for two weeks. She has been doing this November.
Her first PET scan ( Sept. 2016) showed lymph nodes that was involved also with the addition of the para-aortic being involved on the opposite of the colon cancer find.
The second Pet Scan ( early Feb 2017) showed no new places and a big decrease in size of all Lymph nodes involved.
Fast forward to last week. We have a lump on top of shoulder. Its about a inch from the base of her neck. Lump is soft and zero pain or tenderness .
We are seeing her Dr. this week. Just wondering if anyone had a lump show up out of the blue like this .
Right colon
Gross Description
The specimen is received in formalin in one container labeled with the
patient's (Name ) and "right
colon". The specimen consists of a portion of bowel measuring 15.0 x 11.0
x 6.8 cm in greatest dimensions. Two staple margins are identified. The
proximal staple margin is identified, and there is an appendix present.
The ileocecal valve is identified. The serosal surface is pink-tan, and a
darker area is appreciated that is tan-brown to black measuring 2.8 cm.
The specimen is opened along its length revealing white-tan-pink colonic
mucosa and an area of ulceration with an exophytic mass that measures 6.1 x
4.3 x 2.2 cm in greatest dimensions. This mass is within 0.6 cm of the
ileocecal valve, within 3.5 cm of the proximal margin, within 6.7 cm of the
distal margin, and within 1.3 cm of the radial margin. The staple margins
are shaved and submitted. The mass is sampled and submitted. Normal
mucosa is sampled and submitted. The appendix present measures 3.4 x 0.6 x
0.4 cm in greatest dimensions. The serosal surface is pink-tan and
otherwise unremarkable. The appendix is cross sectioned revealing pink-tan
cut surfaces that are otherwise unremarkable. No fecalith is identified.
Representative sections are submitted as per the summary of sections.
SUMMARY OF SECTIONS:
A Proximal margin
B Distal margin
C-G Representative sections of the tumor
H-I Presumed normal colonic mucosa
J-K Representative sections of the appendix
L-V Lymph nodes, 11c
(Cassettes L and M contain one bisected lymph node
each,
cassettes N-V contain multiple single lymph
nodes).
DOS/ab
DIAGNOSIS
Right colon:
Procedure - Right hemicolectomy.
Tumor site - Right colon.
Tumor size - 6.1 cm in greatest dimension.
Macroscopic tumor perforation is not identified.
Histologic type - Adenocarcinoma with mucinous component.
Histologic grade - Low grade.
Microscopic tumor extension - Tumor invades through the muscularis
propria into the subserosal adipose tissue.
All margins uninvolved by invasive carcinoma.
Distance of invasive carcinoma from closest margin - 1.3 cm from
radial
margin.
No history of prior treatment.
Lymph-vascular invasion is present.
Perineural invasion is not identified.
Tumor deposits are present (2) - The largest measuring 0.6 cm.
Seven of twenty-four lymph nodes are positive for metastatic neoplasm
(7/24).
Immunostains on the neoplasm are pending.
Appendix - No pathologic changes
Pathologic staging - pT3 pN2
Her treatment plan is Chemo (oxaliplatin) by port once every two weeks and xeloda for two weeks. She has been doing this November.
Her first PET scan ( Sept. 2016) showed lymph nodes that was involved also with the addition of the para-aortic being involved on the opposite of the colon cancer find.
The second Pet Scan ( early Feb 2017) showed no new places and a big decrease in size of all Lymph nodes involved.
Fast forward to last week. We have a lump on top of shoulder. Its about a inch from the base of her neck. Lump is soft and zero pain or tenderness .
We are seeing her Dr. this week. Just wondering if anyone had a lump show up out of the blue like this .
Right colon
Gross Description
The specimen is received in formalin in one container labeled with the
patient's (Name ) and "right
colon". The specimen consists of a portion of bowel measuring 15.0 x 11.0
x 6.8 cm in greatest dimensions. Two staple margins are identified. The
proximal staple margin is identified, and there is an appendix present.
The ileocecal valve is identified. The serosal surface is pink-tan, and a
darker area is appreciated that is tan-brown to black measuring 2.8 cm.
The specimen is opened along its length revealing white-tan-pink colonic
mucosa and an area of ulceration with an exophytic mass that measures 6.1 x
4.3 x 2.2 cm in greatest dimensions. This mass is within 0.6 cm of the
ileocecal valve, within 3.5 cm of the proximal margin, within 6.7 cm of the
distal margin, and within 1.3 cm of the radial margin. The staple margins
are shaved and submitted. The mass is sampled and submitted. Normal
mucosa is sampled and submitted. The appendix present measures 3.4 x 0.6 x
0.4 cm in greatest dimensions. The serosal surface is pink-tan and
otherwise unremarkable. The appendix is cross sectioned revealing pink-tan
cut surfaces that are otherwise unremarkable. No fecalith is identified.
Representative sections are submitted as per the summary of sections.
SUMMARY OF SECTIONS:
A Proximal margin
B Distal margin
C-G Representative sections of the tumor
H-I Presumed normal colonic mucosa
J-K Representative sections of the appendix
L-V Lymph nodes, 11c
(Cassettes L and M contain one bisected lymph node
each,
cassettes N-V contain multiple single lymph
nodes).
DOS/ab
DIAGNOSIS
Right colon:
Procedure - Right hemicolectomy.
Tumor site - Right colon.
Tumor size - 6.1 cm in greatest dimension.
Macroscopic tumor perforation is not identified.
Histologic type - Adenocarcinoma with mucinous component.
Histologic grade - Low grade.
Microscopic tumor extension - Tumor invades through the muscularis
propria into the subserosal adipose tissue.
All margins uninvolved by invasive carcinoma.
Distance of invasive carcinoma from closest margin - 1.3 cm from
radial
margin.
No history of prior treatment.
Lymph-vascular invasion is present.
Perineural invasion is not identified.
Tumor deposits are present (2) - The largest measuring 0.6 cm.
Seven of twenty-four lymph nodes are positive for metastatic neoplasm
(7/24).
Immunostains on the neoplasm are pending.
Appendix - No pathologic changes
Pathologic staging - pT3 pN2