Need guidance (lots of) with sacral mets and pelvic recurrence

[crybaby]

...I have been trying hard to be offline and just focus on my exams that are starting tomorrow...

Good luck on your exams !!

Take care ...

i have made a new post about the pet ct scan. they don't look so good.

[crybaby]

Hello crybaby,

When I get back I will be working on an annotated retrospective review of your dad's past 5 years, based on the timeline you gave above, but I will need some additional information that would most likely be found in these two documents:

1. Surgery report for the TME / LAR / iIeostomy surgery, April 10, 2017
2. Pathology report for the resected rectal tumor specimen from the April 10, 2017 surgery above.

Would you be able to look in your files to see if you can find these two reports?

Thank you

Oh yes, I finally found those surgery and pathology report.
Surgery report
Through midline laparotomy incision abdomen was opened. Firm growth in proximal rectum reaching upto lower 3rd of rectum noted. Entire sigmoid colon + rectum along with mesorectum was mobilized upto pelvic floor safeguarding both ureters. LAR + TME was done.

Pathology report
Gross description -> received specimen of LAR, measuring 17cm in length. On cutting open an ulceroinfiltrative tumor is identified involving the rectal wall circumferentially for a length of about 5.5cm. This tumor is 9cm and 1.8 cm from proximal and distal resection margin respectively. Maximum tumor thickness is 1cm and it extends into pericolic fat, reaching about 5mm away from circumferential margin.

Microscopic description -> sections from tumor reveal features of moderately differentiated adenocarcinoma. Tumor is infiltrating deep into muscularis propria and is invading perirectal fat. It is reaching close (2mm) to circumferential resection margin. No lymphovascular or perineual invasion is seen. Proximal and distal resection margins are free from tumor. 12 lymph nodes dissected do not show any evidence of tumor mets.

Type -> T3N0MX