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Posted: January 12th, 2023
J.C is an 82-year-old white man who was evaluated by a GI specialist due to abdominal discomfort, loss of appetite, weight loss, weakness, and occasional nausea.
Past Medical History (PMH):
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation is controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.
Labs:
Hb 12.7 g/dl; Hct 38.8% WBC 8.2; Glycemia 74mg/dl; Creatinine 0.8 mg/dl; BUN 9.8 mg/dl; AST 21 U/L ALT 17 U/L; Bil T 1.90 mg/dl; Ind 0.69 mg/dl; Dir 1.21 mg/dl.
Diagnostic test:
Endoscopic Ultrasound of the Pancreas. Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma.
Case Study Questions:
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Please name the potential most common sites for metastasis on J.C and why?
What are tumor cell markers and why tumor cell markers are ordered for a patient with pancreatic cancer?
Based on the case study described, proceed to classify the tumor based on the TNM Stage classification. Why is this classification important?
Discuss characteristics of malignant tumors regarding their cells, growth, and ability to spread.
Describe the carcinogenesis phase when a tumor metastasizes.
Choose the tissue level that is affected in the patient discussed above: Epithelial, Connective, Muscle, or Neural. Support your answer.
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook.
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The potential most common sites for metastasis on J.C are the liver and the lungs. Pancreatic cancer has a tendency to spread to these organs due to the proximity of the pancreas to the liver and the blood vessels that travel to the lungs.
Tumor cell markers are specific proteins or genetic material that are found in cancer cells, but are not typically found in healthy cells. They can be used to help diagnose cancer, determine the type of cancer, and monitor treatment response. Tumor cell markers are ordered for a patient with pancreatic cancer as they can help in identifying the specific type of cancer and determining the stage of the disease.
Based on the case study described, the tumor can be classified as T3 N1M1. This is because the tumor is located in the head of the pancreas, it is more than 2 cm in size, and it has infiltrated the Wirsung duct and the superior mesenteric vein. Additionally, there is evidence of one lymph node being involved and the presence of distant metastasis. This classification is important as it helps to determine the prognosis and guide treatment decisions.
Malignant tumors are characterized by their ability to invade and destroy surrounding tissue, as well as their ability to spread to other parts of the body. They also have abnormal cells that divide and grow in an uncontrolled manner.
Carcinogenesis is the process by which normal cells turn into cancer cells. When a tumor metastasizes, it means that the cancer cells have spread from their original location to other parts of the body, typically through the bloodstream or lymphatic system.
The tissue level affected in the patient discussed above is epithelial. This is because pancreatic cancer is a type of ductal adenocarcinoma, which develops from the cells that line the ducts of the pancreas. This type of cancer is known to be a malignant tumor, which can invade and destroy surrounding tissue and can spread to other parts of the body.
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