CLINICAL HISTORY

This 83 year old female with a history of non-small cell lung cancer status post left upper lobectomy and adjuvant chemotherapy, deep vein thrombosis and pulmonary embolism on coumadin, chronic obstructive pulmonary disease, and extensive sigmoid diverticulosis presented to an outside hospital with a lower GI bleed and found to have an ulcerated cecal mass, as well as, a polyp concerning for a villous adenoma during colonoscopy. She was stabilized, coumadin was held, and she was scheduled for outpatient follow up. Two weeks later, the patient presented again to the outside hospital emergency department with bright red blood per rectum and was subsequently transferred to UPMC Presbyterian for further management. The patient underwent a right hemicolectomy due to extensive blood loss and multiple peritoneal implants were noted during surgery

INTRAOPERATIVE DIAGNOSIS

PERITONEAL IMPLANT, BIOPSY (frozen section)
POSITIVE FOR MALIGNANCY CONSISTENT WITH POORLY DIFFERENTIATED CARCINOMA