A sample for the stanlean tumour board presentation

1. A CASE OF GASTROCOLIC
FISTULA
PROF DR MANIVANNAN SIR UNIT-S7

2. CASE SUMMARY
• 55/M
• Upper abdominal pain x 7 months.
• vomiting on and off, occasionally feculent x 7 months
•Loose stools x 7 months
•No comorbidities
•No prior surgeries

3. EXAMINATION
• ECOG 3
• Emaciated.
• Pallor +
• B/L pedal edema +
• P/A- no tenderness, warmth .Vague mass palpable in the left
hypochondrium, 6x6 cm, irregular in shape, upper border felt,
mobility restricted. No virchow’s node.
• Other system examination- normal
• DRE- No deposits

4. INVESTIGATIONS
HB/TLC/PLT 7.7/13000/5.48
Urea/ creatinine 21/0.6
T.B/D. B 0.2/0.1
OT/PT/ALP 15/12/129
ALBUMIN 2.4
PT 17.7 s

5. USG ABDOMEN AND PELVIS
Suspicious irregular thickening of the body of the stomach wall noted
with max thickness of 12mm

6. CECT ABDOMEN
• Ill defined exophytic growth measuring approximately 5.5 x 6 x 4 cms
(APXTRXCC) noted arising from the lesser curvature of the stomach, lesion
appears to be infiltrating and communicating with the gastric lumen and
transverse colon lumen.
• Loss of fat plane b/w growth and the pancreatic body.
• Liver normal in size, well defined peripherally enhancing lesion measuring
4x4x4.1 cm noted in the segment 8/4a
• Multiple enlarged necrotic left gastric, infrapyloric, mesenteric nodes noted
• Multiple subcentimetric para-aortic nodes noted.
• Minimal free fluid noted in the pelvis

7. OGD SCOPY
• Lobulated growth noted along greater curvature with reflux of
feculent matter from within.
• Biopsy taken
• IMPRESSION : ? Malignant Growth, ? Gastrocolic Fistula

8. HPE report 11/06/2022 – Outside Biopsy
Infiltrating Moderately differentiated adenocarcinoma.

9. CT THORAX
• Centriacinar emphysematous changes noted in the bilateral lung
fields.
• No evidence of pulmonary metastasis

10. WORKING DIAGNOSIS
• CARCINOMA STOMACH with GASTROCOLIC FISTULA
• T4bN2M1

12. PLAN
• Palliative resection with diversion procedure/feeding jejunostomy
• F/b chemotherapy

13. TUMOUR BOARD CONSENSUS

14. THANK YOU