Familial colon cancer

These images are from a 38-year-old man who was found to have heme positive stool. His father and two uncles died of colon cancer before the age of fifty. Panel A: The initial study was a barium enema (although a colonoscopy is more commonly used as the initial diagnostic study for heme positive stools). The barium enema reveals a filling defect in the cecum (arrow). Panels B and C: A CT scan of the abdomen shows a large exophytic mass (colored in pink in panel C) involving the cecum (arrows). Panel D: Colonoscopy reveals that the large exophytic lesion occupies most of the cecum. Adenocarcinoma was confirmed by biopsy. Despite the size of the lesion, the tumor had not spread beyond the colonic wall.