英文版病例汇报.ppt

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1、Case reportCase ReportHarbin Medical University cancerHarbin Medical University cancer hospitalhospitalA case consultation : Liver metastasis after resection of rectal cancer HeiLongJiang tumor hospital.China Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalName:Xing

2、XXGender:maleAge:63 years oldECOG:0Personal profileHarbin Medical University cancerHarbin Medical University cancer hospitalhospitalChief complaintResection of rectal cancer before 6 years ,with liver metastasis for 1 month.Harbin Medical University cancerHarbin Medical University cancer hospitalhos

3、pitalPresent history Extended radical resection for rectal cancer (Miles ) was performed before 6 years in this hospital. The tumor was located under the peritoneal fold ,with a size of 6*5*7cm, invading wall of intestine.Harbin Medical University cancerHarbin Medical University cancer hospitalhospi

4、talPresent history The pathologic diagnosis Rectal: moderately differentiated adenocarcinoma and mucinous adenocarcinoma with disc protrude type Invading wall of intestine A negative upper margin of resection Number of positive lymph nodes 0/22Harbin Medical University cancerHarbin Medical Universit

5、y cancer hospitalhospitalPresent history Clinical diagnosis based on the pathologic stage Rectal adenocarcinoma after resection pT4aN0M0 BHarbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent history Adjuvant Chemotherapy after surgery FOLFOX *8 Cycles Oxaliplatin

6、200mg d1 ivgtt; Leucovorin 300mg d1-5 ivgtt; 5-Fu 1g d1-5 ivgtt; Repeated every 2weeks Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent history Follow up 2009.08-2014.05 CEA and CA199 monitoring and routine CT scanning were conducted every 3 month within 2 yea

7、rs and 6 months within 5 years after the surgery. Colonoscopy was performed every year.Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent history Recurrence 2015-05-23 Upper Abdominal Enhancement CT : Liver Metastasis .Harbin Medical University cancerHarbin Medi

8、cal University cancer hospitalhospital 肝转移病灶Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalA metastases with a maximum diameter of 14 cm diameter) was observed in the left lobe of the liver2015.05.23Plain CTPortal PhaseHepatic arterial phasePresent history Recurrenc

9、e Tumor markers： CEA 113.2ng/ml(0-5) CA199 135.3U/ml(0-37) NSE 23.77ng/ml(0-15.2) AFP 4.24ng/ml(0-7)Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent history Recurrence 2015-06-01 Left liver lesion biopsy: Poorly differentiated carcinoma, consistent with metast

10、atic carcinoma.Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent history Recurrence 2015-06-01 Colonoscopy and Chest CT was Tumor Free.Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalChest CTChest CT2015.05.28 Pelvic CT2015.05.2

11、8 Pelvic CTPresent diagnosisRectal cancer after resection pT4aN0M0 B Liver metastasisHarbin Medical University cancerHarbin Medical University cancer hospitalhospital RAS Gene Test2015-6-11 KRAS/NRAS WTHarbin Medical University cancerHarbin Medical University cancer hospitalhospital 临床诊断： 直肠癌术后pT4N0

12、M0 B期 肝转移 Present historyChemotherapy after Recurrence XELOX *1 Cycles Oxaliplatin 200mg d1 ivgtt; Capecitabine 1500mg am 2000mg pm d1-14 po; Repeated every 3 weeks Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalPresent historyTumor marker after ChemotherapyHarbin M

13、edical University cancerHarbin Medical University cancer hospitalhospitalCEACA1992015.05.29Before chemotherapy 113.2135.32015.06.23 1 course later168.2157.7CEA：0-5ng/mlCA199:0-37U/ml Following treatmentResection?Chemotherapy ？Portal vein embolization therapy？Chemotherapy combination with HAI (Hepatic Arterial infusion)？Harbin Medical University cancerHarbin Medical University cancer hospitalhospitalHarbin Medical University cancerHarbin Medical University cancer hospitalhospital