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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed As Rectosigmoid CA, Biopsy Shows No Malignancy. What Next ?

my mom has been clinically diagnosed as Rectosigmoid CA.......her CECT shows features of heterogenously enhancing transmural stricturous wall thickening involving long segment of rectum and rectosigmoid with invasion of uterine stump & parametrium associated with pericolic fat stranding suggestive of neoplastic etiology....but biopsy says no feature of malignancy .........what should we do next?
Mon, 15 Oct 2012
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM
It would be nice if you could post the histopathology report too.
There is a clinical suspicion and radiological evidence of malignancy. However, no features of malignancy on biopsy.
This could be due to biopsy from non-representative site.
A repeat biopsy should be done.

A diagnosis of malignancy on histopathology is a must because it is a 100% confirmatory test.
No treatment can be given on clinical suspicion or radiological evidence of malignancy.
So, repeating the biopsy from representative site.
But a word of caution, do get the slides reviewed from a second pathologist for a second opinion.

Thanks and take care
Dr Shailja P Wahal
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Diagnosed As Rectosigmoid CA, Biopsy Shows No Malignancy. What Next ?

Hello and welcome to HCM It would be nice if you could post the histopathology report too. There is a clinical suspicion and radiological evidence of malignancy. However, no features of malignancy on biopsy. This could be due to biopsy from non-representative site. A repeat biopsy should be done. A diagnosis of malignancy on histopathology is a must because it is a 100% confirmatory test. No treatment can be given on clinical suspicion or radiological evidence of malignancy. So, repeating the biopsy from representative site. But a word of caution, do get the slides reviewed from a second pathologist for a second opinion. Thanks and take care Dr Shailja P Wahal