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Suggest Tests To Diagnose Peritoneal Disease

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Posted on Mon, 23 Feb 2015
Question: Advise needed. Letter from oncologist states poss peritoneal disease .but ct report does not mention peritoneal disease. Im
Confussed? Please see attached letter and report .
doctor
Answered by Dr. S. Samanta (33 minutes later)
Brief Answer:
Two opinions don't vary in terms of staging/management

Detailed Answer:
Respected Madam,

Thanks for writing to us and I'll be happy if I can resolve your concerns/confusion...!

Well, after going through your father's reports enclosed herewith, I might revise the statement of radiation-oncologist that ''he is suffering from inoperable chemoresistant colorectal carcinoma with POSSIBLE PERITONEAL, RETROPERITONEAL, LIVER AND LUNG METASTASIS (27/01/15)!'

Whereas contrast CT study on 14/01/15 reveals evidence of possible mets in aortocaval nodes, liver, left adrenal and both lungs... concluding disease progression!

Therefore, it was the radiation -oncologist's clinical impression/opinion that POSSIBLE PERITONEAL, RETROPERITONEAL, LIVER AND LUNG METASTASIS because left adrenal and lymph nodes were involved!

I don't think the two opinions differ in terms of staging/management or conclusion.

Hope I could explain the thing; however, PET-CT Scan sometimes is helpful to resolve such contradictions.

wishing your father a better life; thanks and regards,


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. S. Samanta (58 minutes later)
Well its been confirmed that adrenal gland is not meatastases and nor is the upper lobe nodule.

So there is a aortocaval node, 1 liver met and 1 sub pleural nodule. But radiologist has not said peritonium disease .does aortocaval node mean peritoneal?

I dont know y letter says peritoneal .
doctor
Answered by Dr. S. Samanta (8 hours later)
Brief Answer:
No; aortocaval node doesn't mean peritoneal

Detailed Answer:
Thanks for your response!

No, aortocaval node doesn't mean peritoneal but if the patient present with ascites or peritoneal effusion that is positive for tumor cells or a peritoneal biopsy shows tumor deposits then one can say that peritoneum is involved!

Hope you got the answer....

regards,
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. S. Samanta

Pathologist and Microbiologist

Practicing since :2004

Answered : 1107 Questions

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Suggest Tests To Diagnose Peritoneal Disease

Brief Answer: Two opinions don't vary in terms of staging/management Detailed Answer: Respected Madam, Thanks for writing to us and I'll be happy if I can resolve your concerns/confusion...! Well, after going through your father's reports enclosed herewith, I might revise the statement of radiation-oncologist that ''he is suffering from inoperable chemoresistant colorectal carcinoma with POSSIBLE PERITONEAL, RETROPERITONEAL, LIVER AND LUNG METASTASIS (27/01/15)!' Whereas contrast CT study on 14/01/15 reveals evidence of possible mets in aortocaval nodes, liver, left adrenal and both lungs... concluding disease progression! Therefore, it was the radiation -oncologist's clinical impression/opinion that POSSIBLE PERITONEAL, RETROPERITONEAL, LIVER AND LUNG METASTASIS because left adrenal and lymph nodes were involved! I don't think the two opinions differ in terms of staging/management or conclusion. Hope I could explain the thing; however, PET-CT Scan sometimes is helpful to resolve such contradictions. wishing your father a better life; thanks and regards,