SURGERY RESIDENT BLOG

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ABSITE MCQs: Topic: Recurrrent rectal cancer

A 55 y/o man undergoes low anterior resection of a low rectal cancer returns to clinic 6 months later with constipation. You perform anoscopy in the office and notice a mass at the previous suture line. Biopsies show adenocarcinoma. After a metastatic disease workup, the next appropriate step is:

a. Do nothing

b. Chemotherapy with Leucovorin

c. 5000 rads of XRT

d. Abdominal perineal resection

Answer d: Recurrence at the suture line following low anterior resection demands abdomino-perineal resection unless the patient has metastatic disease that precludes surgery. You should perform a thorough metastatic workup in patients with recurrent cancer (Abdominal/Pelvic CT, CXR, LFTs, and CEA in this patient.)

ABSITE KILLER Q&A

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