This is a 46-year-old-male with a history of adenocarcinoma of the transverse colon. In March of 1997, the patient underwent an extended right colectomy with resection of the greater curvature of the stomach due to local invasion, stage T4N0M0. A course of adjuvant chemoradiotherapy was administered following surgery. The patient was examined in February 1999 due to diarrhea and 20 pound weigh loss.

    Colonoscopy with biopsy performed in February 1999 confirmed a recurrence. Spiral CT (W/O & with contrast) of the abdomen and pelvis at this time revealed a "Normal post surgical CT … No significant change in comparison to the study of July 1998". Images with CEA-Scan in March of 1999 revealed a large area of uptake in the mid-upper abdomen.

    Surgery revealed a poorly differentiated mucinous adenocarcinoma extending through all layers of bowel and out to the serosa with perforation. Adjacent sections of mesentery and small bowel contained mucin-producing metastatic lesions. Fourteen lymph nodes were identified and found to be negative for disease (Stage T4N0Mx). Therefore, surgery confirmed the CEA-Scan findings of extensive local recurrence with no apparent distant metastatic involvement.

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