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Post Colectomy In 2015 Followed By 5 Cycle Chemotherapy In
Question: Post Colectomy in 2015 followed by 5 cycle chemotherapy in 2016.
At 65 yrs, in 2015 diagnosed Ca Colon. APR to EEA done.. Histopath: Grade2 Mod diff adeno ca-Intestinal variant. Duke stage C. TNM: PT3.PN1.PMX
Post Chemo CT: No residual lesion in colon or lN or peripheral deposits.. Diffuse grosss osteoporosis with D10 vertebral body fracture and Ant wedging
Now Follow Up with Fresh complaint: Back pain
Recently started complaining of back pain. Review CT scan done on XXXXXXX 9th 2021 showed no evidence of residual mass lesion in large colon. D8 vertebral body sclerosis with ant wedge compresssion collapse and thin strip of paravertebral soft tissue component. suspicious of free osseous secondaries. D10 ant wedge compresssion fracture with associated D9/D10 iVD degeneration. Mod cardiomegaly with predominant LV chamber enlargement. Faint ground glass in Rt LL lat basal segment CORADS 3.
On 20 XXXXXXX PET Scan was followed and report attached.
My Question:
1 What does uploaded report of PET suggest
2) There is a back pain. Is it disc changes or secondaries?
3) If secondaries, what is the next best treatment
4) One ONcO says, there is no significant uptake... the person should be given sx treatment with zolendronic acid etc. THe Rad ONCO says, a stereotactic radio surgery is needed followed by chemo.
Please help.
At 65 yrs, in 2015 diagnosed Ca Colon. APR to EEA done.. Histopath: Grade2 Mod diff adeno ca-Intestinal variant. Duke stage C. TNM: PT3.PN1.PMX
Post Chemo CT: No residual lesion in colon or lN or peripheral deposits.. Diffuse grosss osteoporosis with D10 vertebral body fracture and Ant wedging
Now Follow Up with Fresh complaint: Back pain
Recently started complaining of back pain. Review CT scan done on XXXXXXX 9th 2021 showed no evidence of residual mass lesion in large colon. D8 vertebral body sclerosis with ant wedge compresssion collapse and thin strip of paravertebral soft tissue component. suspicious of free osseous secondaries. D10 ant wedge compresssion fracture with associated D9/D10 iVD degeneration. Mod cardiomegaly with predominant LV chamber enlargement. Faint ground glass in Rt LL lat basal segment CORADS 3.
On 20 XXXXXXX PET Scan was followed and report attached.
My Question:
1 What does uploaded report of PET suggest
2) There is a back pain. Is it disc changes or secondaries?
3) If secondaries, what is the next best treatment
4) One ONcO says, there is no significant uptake... the person should be given sx treatment with zolendronic acid etc. THe Rad ONCO says, a stereotactic radio surgery is needed followed by chemo.
Please help.
Brief Answer:
Answer
Detailed Answer:
Hi there
Thanks for the query
I have read through your query and viewed the attached reports.
Uploaded report of PET suggests that D8 fracture may have metastasis but D10 does not have evidence of metastasis.
Back pain is due to collapse and fracture of the spine bones at D8 and D10.
Usually to reduce back pain due to secondaries or metastasis, radiotherapy is helpful. This option can be discussed with stereotactic radiotherapist.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Aashish Raghu
Answer
Detailed Answer:
Hi there
Thanks for the query
I have read through your query and viewed the attached reports.
Uploaded report of PET suggests that D8 fracture may have metastasis but D10 does not have evidence of metastasis.
Back pain is due to collapse and fracture of the spine bones at D8 and D10.
Usually to reduce back pain due to secondaries or metastasis, radiotherapy is helpful. This option can be discussed with stereotactic radiotherapist.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Aashish Raghu
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Kampana
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