Case report
A 54-year-old man was admitted to the Affiliated Hospital of Guangxi
Medical University in August 2018, presenting with a 2-month history of
hypodynamics accompanied by poor appetite and weight loss (15 kg). The
patient had no significant medical history and no family history of
cancer, and he was a non-smoker. A physical examination revealed no deep
tenderness at the left lower quadrant of the abdomen and no rebound
tenderness on palpation. Laboratory data revealed glandular tumor
markers: (CEA) 7.3 ng/ml; (AFP) 1.74 ng/ml; (CA125) 12.3 U/ml; (CA15-3)
15.1 U/ml; and (CA19-9) 180.7 U/ml. Histopathology revealed hepatic
curve ascending colon (5 points), tubular-villous adenoma, partial
regional carcinogenesis, and highly differentiated intramucosal
adenocarcinoma. Computed tomography (CT) of the abdomen revealed the
possibility of colorectal cancer invading the liver, gall bladder, and
pancreas/duodenum (Figure1). Colonoscopy identified a tumor located in
the hepatic flexure of the colon (Figure 2). The diagnosis of colon
cancer was confirmed by histopathological examination.
The patient underwent four rounds of chemotherapy, subsequent to 4
months of follow up examinations by CT and colonoscopy. The tumor
exhibited stabilized disease (SD). However, an abdominal X-ray revealed
an incomplete
ileus
(Figure 3).
Laboratory tests revealed the following blood and routine liver and
kidney function data: (WBC) 3.02×109/L;* (RBC)
3.41×1012/L;* (HGB) 80 g/L; (HCT) 25.5%;* (MCV) 74.6
fL;* (MCH) 23.5 pg;* (MCHC) 315 g/L; (IBIL) 4.3 µmol/L; (TRF) 1.5 g/L;*
(TP) 51 g/L;* (ALB) 29.9 g/L;* (GLO) 21.1 g/L; and (RBP) 15.3 mg/L. The
following glandular tumor markers were detected: (CEA) 7.77 ng/ml; (AFP)
2.33 ng/ml; (CA125) 32.5 U/ml; (CA15-3) 15.2 U/ml; (CA19-9) 357.3 U/ml;
and (PA): 108.9 mg/L. Preoperative examination showed that the patient
had poor nutritional status and an intestinal obstruction. Preoperative
supplementation with human serum albumin and parenteral nutrition
improved the nutritional status of the patient, and he eventually
underwent surgery.