Instructions
You are a medical student on placement in the surgical outpatient clinic at Broome Hospital. Clarence Andrews, 61, joins by video from Fitzroy Crossing with his niece and the Aboriginal Health Practitioner, two weeks after a colonoscopy for three months of looser stools with dark blood.
Explain the biopsy result to Mr Andrews
Discuss your initial management plan with him
- He has not yet been told the result
- You do not need to take a history or examine him
- The examiner will ask you one question at the end
Colonoscopy, Broome Hospital, two weeks ago
Complete to the caecum. Ulcerated, friable mass about 4 cm long at 30 cm from the anal verge, involving half the circumference and narrowing the lumen; the scope passed. Biopsied and tattooed. Two 5 mm polyps in the ascending colon removed.
Histopathology
Mass: invasive, gland-forming, moderately differentiated; mismatch repair testing to follow. Polyps: tubular adenomas with low-grade dysplasia, completely removed.