Pathophysiology of Well differentiated Adenocarcinoma
Adenocarcinoma of the colon and rectal area also known as colorectal cancer can occur in both male and female but common among females. It can occur at any age peaking age at 40-50 years old. In the case of our patient, precipitating factors identified are as follows: diet with high fat intake and refined product intake with low fiber diet and smoking history (1 pack per day for 10 years). On the other hand, the predisposing factor identified is related to family history of breast cancer. Genetically, colorectal cancer represents complex disease and genetic alterations are often associated with progression from 3 malignant lesions (adenoma) to invasive carcinoma with mutation and damage of APC and beta catenine along WNT pathway signaling. With exposure to carcinogen, disturbance to proto oncogene lead to activation of oncogene leading to altered cell differentiation and altered cell multiplication. Thus, development of malignant tumor (colorectal cancer). Our patient diagnosed with cell-differentiated adenocarcinoma of colorectal area stage II B. With progression as tumor grows in size and number lead to obstruction of GI tract, invasion of intestinal lining and invasion of the vascular structure. With obstruction of the GI tract, and narrowing of the intestinal lumen, lead to fecal impaction and accumulation of solid waste. With invasion of the vascular structure, ulceration of the blood vessels occurred with bleeding. With invasion of intestinal lining, without perforation yet possible exposure of the peritoneal cavity is inevitable possible complications are as follows: peritonitis and sepsis. With continued progression, metastization to adjacent organs is also inevitable to leading to formation of secondary tumor affecting site. With the repetition process of the affected organs, multiple organ failure is inevitable and death is the probable outcome.
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