英文版病例汇报

CasereportCaseReportHarbinMedicalUniversitycancerhospitalAcaseconsultation:LivermetastasisafterresectionofrectalcancerHeiLongJiangtumorhospital.ChinaHarbinMedicalUniversitycancerhospitalName:XingXXGender:maleAge:63yearsoldECOG:0PersonalprofileHarbinMedicalUniversitycancerhospitalChiefcomplaintResectionofrectalcancerbefore6years,withlivermetastasisfor1month.HarbinMedicalUniversitycancerhospitalPresenthistoryExtendedradicalresectionforrectalcancer(Miles)wasperformedbefore6yearsinthishospital.Thetumorwaslocatedundertheperitonealfold,withasizeof6*5*7cm,invadingwallofintestine.HarbinMedicalUniversitycancerhospitalPresenthistoryThepathologicdiagnosis•Rectal:moderatelydifferentiatedadenocarcinomaandmucinousadenocarcinomawithdiscprotrudetype•Invadingwallofintestine•Anegativeuppermarginofresection•Numberofpositivelymphnodes0/22HarbinMedicalUniversitycancerhospitalPresenthistoryClinicaldiagnosisbasedonthepathologicstageRectaladenocarcinomaafterresectionpT4aN0M0ⅡBHarbinMedicalUniversitycancerhospitalPresenthistoryAdjuvantChemotherapyaftersurgery•FOLFOX*8CyclesOxaliplatin200mgd1ivgtt;Leucovorin300mgd1-5ivgtt;5-Fu1gd1-5ivgtt;Repeatedevery2weeksHarbinMedicalUniversitycancerhospitalPresenthistoryFollowup•2009.08-2014.05CEAandCA199monitoringandroutineCTscanningwereconductedevery3monthwithin2yearsand6monthswithin5yearsafterthesurgery.Colonoscopywasperformedeveryyear.HarbinMedicalUniversitycancerhospitalPresenthistoryRecurrence•2015-05-23UpperAbdominalEnhancementCT:LiverMetastasis.HarbinMedicalUniversitycancerhospital•肝转移病灶HarbinMedicalUniversitycancerhospitalAmetastaseswithamaximumdiameterof14cmdiameter)wasobservedintheleftlobeoftheliver2015.05.23PlainCTPortalPhaseHepaticarterialphasePresenthistoryRecurrence•Tumormarkers：CEA113.2ng/ml(0-5)CA199135.3U/ml(0-37)NSE23.77ng/ml(0-15.2)AFP4.24ng/ml(0-7)HarbinMedicalUniversitycancerhospitalPresenthistoryRecurrence•2015-06-01Leftliverlesionbiopsy:Poorlydifferentiatedcarcinoma,consistentwithmetastaticcarcinoma.HarbinMedicalUniversitycancerhospitalPresenthistoryRecurrence•2015-06-01ColonoscopyandChestCTwasTumorFree.HarbinMedicalUniversitycancerhospitalChestCTChestCT2015.05.28PelvicCT2015.05.28PelvicCTPresentdiagnosisRectalcancerafterresectionpT4aN0M0ⅡBLivermetastasisHarbinMedicalUniversitycancerhospitalRASGeneTest2015-6-11KRAS/NRASWTHarbinMedicalUniversitycancerhospital临床诊断：直肠癌术后pT4N0M0ⅡB期肝转移PresenthistoryChemotherapyafterRecurrence•XELOX*1CyclesOxaliplatin200mgd1ivgtt;Capecitabine1500mgam2000mgpmd1-14po;Repeatedevery3weeksHarbinMedicalUniversitycancerhospitalPresenthistoryTumormarkerafterChemotherapyHarbinMedicalUniversitycancerhospitalCEACA1992015.05.29Beforechemotherapy113.2135.32015.06.231courselater168.2157.7CEA：0-5ng/mlCA199:0-37U/mlFollowingtreatmentResection?Chemotherapy？Portalveinembolizationtherapy？ChemotherapycombinationwithHAI(HepaticArterialinfusion)？HarbinMedicalUniversitycancerhospitalHarbinMedicalUniversitycancerhospital