I have a young female patient with a rectal mass 3cm from anal verge. Biopsy has been done twice and both times showed only high grade dysplasia. MRI shows it to be a T3 lesion. No lymph nodes. Should she be started on neoadj therapy??
Discuss it in a multidisciplinary committee, it is a question that involves considering many details
So far, I would not suggest neoadjuvant therapy. The lesion should be excised with sufficient margin and should be examined histologically. Further Management should be done based on the pathological results. In case of a rectal cancer beyond pT1G1 abdominoperineal resection will be unavoidable.
i agree no oncologist will give it......either repeat the biopsies or remove it with a local excision or formal resection....then decide after the formal pathology report is out..
I recommend wide local excision and long term follow up.
How big is the mass? What type of biopsy did you do? What is the proximal extent of this mass?
Bulky but non obstructing mass 2cm from anal verge extending from 6 to 2 o clock. Punch biopsy was taken. Tumor extends proximal upto mid rectum. T3 as defined by MR.
It must be possible to obtain an appropriate (snare or excisional) biopsy of such a mass.
If repeated biopsies would not be sufficient to prove malignancy then indeed complete local excision will be necessary to check for invasion.
As the initial question is 6 months back I would be interested to learn how management of this case has been done.
- Badges
- Science topic
- Similar topics
- Geoscience
- Asia
- India