Ancylostoma
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I think USMLE world says that Bleeding adenocarcnomas are most commonly on the right side and thus the ascending colon. If the carcinoma bleeds it is more likely to be right sided, if it obsturucts its more likely to be on the left side. Overall the most common place is the sigmoid colon. Thats my understanding however it would help if maybe you could provide the explanation to the question. Atleast then I would know what you were talking about exactly. Let me know what the Q says.
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| malignant
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hi,
Q was routine colonoscopy reveals a 5 cm mass, gives micriscopic feature, then asks the most common location.
No signs and symtoms given.
The explanation clearly says what I said before its colon adeno carcinoma only 21% people responded positively . thats what confused me, well personally I wud go with Dr Golijan.Whay do u say?
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| Ancylostoma
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Does it give anytype of gross features?
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| Ancylostoma
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Topics: 42
Posts: 637
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Robbins 7th edition (latest) clearly says the rectosigmoid colon is where 55% of the cancers occur, while 22 % in the ascending colon. I guess that means I would go with robbins and goljan.
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| Ancylostoma
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Topics: 42
Posts: 637
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oh yeah if it says that it present with a protruding mass, then that may be the reason. Right sided leasions ten to protrude into the lumen, left sided tend to grow around the lumen (napkin-ring). Maybe in that case they wanted us to know that first that is was a fungating mass and thus a right sided lesion and second that the most common location on the right side is ascending colon. Whatever it is , if you write usmle world support explaining to them that goljan and robbins say rectosigmoid, and tell them the index # and q # of the test they will respond with the reasoning. Usually only takes them a day. Untill you get there response though, I would go with rectosigmoid. Let me know what they said!
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| malignant
Topics: 2
Posts: 24
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Yes I agree with you, UW should have explained like you did, it totally makes sense.
But it says most common colon cancer site, if it is fungating mass then they are right like you said. Thanks for checking out in robins.I will mail them If I get time today.
Best of luck.
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| Ancylostoma
Forum Guru
Topics: 42
Posts: 637
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Just pm me when and let me know...thanks
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