Present illness: A 49-year-old man was seen with adenocarcinoma of the rectum. Approximately 3 months earlier the patient noted blood in his stools without pain. Ten weeks before, the physical examination was normal, but the stool was guaiac positive.
During the next 6 weeks, the patient noted a decreasing caliber of stools and 1 month before presentation, blood, and mucus admixed with stools. Past Medical History No diarrhea, abdominal pain, nausea, vomiting, or weight loss Weight: 92.7 kg Blood pressure: 140/80 mm Hg (at presentation) Other vital signs and physical examination: Normal Colonoscopic Examination Exophytic mass 15 cm from the anal verge A polyp (0.6 cm in diameter) in the descending colon A second polyp (1.25 cm in diameter) in the distal rectal vault Pathological Examination Rectal mass showed moderately differentiated adenocarcinoma arising in a villous adenoma with…
