Staging scans for a 72-year-old man with newly diagnosed colon cancer seemed to deliver the worst possible news: countless metabolically active nodules scattered across the lining of his abdomen. Biopsies told a different story. The nodules were pus granulomas, a benign inflammatory reaction to degraded plant material, according to a case report in the Journal of Surgical Case Reports published Sept. 18.
Getting that answer right changed his treatment path. The authors, Susanna Li and Cameron Law of the colorectal surgery department at Prince of Wales Hospital in Randwick, Australia, note that cancer on the peritoneum, the membrane lining the abdomen, signals stage IV colon cancer, which may not be removable with surgery. Stage III disease, by contrast, is typically managed with surgery followed by chemotherapy, the approach reflected in the NCCN colon cancer guidelinesthe authors cite.
