J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort,
loss of appetite, weight lost, 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,
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:
1. Please name the potential most common sites for metastasis on J.C and why?
2. What are tumor cell markers and why tumor cell markers are ordered for a patient with
pancreatic cancer?
3. Based on the case study described, proceed to classify the tumor based on the TNM Stage
classification. Why this classification important?
4. Discussed characteristic of malignant tumors regarding it cells, growth and ability to spread.
5. Describe the carcinogenesis phase when a tumor metastasizes.
6. Choose the tissue level that is affected on 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 current APA style with
support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding
additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two
classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date
Solution:
Please name the potential most common sites for metastasis on J.C and why?
When reproduction of the cancer cells occurs, they can invade healthy tissues that may be surrounding the original tumor hence the name metastatic cancer. The spread of metastasis can either occur through the lymphatic, blood, or both routes. In the case of J.C, the most common sites for metastasis include the liver and peritoneum (American Cancer Society, 2021). Other potential sites include the lungs, bones, and brain……Click link below to purchase full tutorial at $5