u/Acrobatic_Winter9157

Please let me know how aggressive or treatable does it look?🙏🙏🙏
Biopsy::
001. MULTIPLE (4) LINEAR CORES RANGING FROM 0.8CM TO 1.8CM (001, 002) (NTL)
MICROSCOPIC EXAMINATION:
SECTION SHOWS LIVER PARENCHYMA INFILTRATED BY POORLY DIFFERENTIATED CARCINOMA
ADVISE: IHC (5-8 MARKERS) FOR FURTHER CHARACTERIZATION

POSITRON EMISSION TOMOGRAPHY AND NON DIAGNOSTIC CT:
296-370 MBq 18F-FDG was administered I.V.& Images were taken after 1hr. from skull base to mid thigh. CT scan was done for attenuation correction & localization. Images of brain were also acquired.
Finding:
Liver is enlarged in size (~22.1cm in maximum cranio caudal extent). Multiple metabolically active discrete and coalescent ill-defined hypodense lesions are seen in both lobes of liver (largest measuring ~13.2 x 8.3cm, SUV max 31.6 involving segments III, IV, V & VIII with areas of internal necrosis.
Multiple mildly metabolically active & inactive lymphnodes are seen in left supraclavicular (2.6 x 2.1cm, SUV max
2.4), left internal mammary, right anterior epiphrenic, paracardiac (1.9 x 1.0cm, SUV max 2.8), periportal, portocaval, peripancreatic, retrocaval, aortocaval, paraaortic, celiac axis and SMA regions.
Multiple collaterals are noted in abdominal region.
Left kidney appears relatively smaller in size. Diffuse increased tracer uptake is noted in dilated pelvicalyceal system of left kidney. Perinephric strandings are noted. US correlation is suggested.
Spleen is enlarged in size (~16.2cm) and shows physiological tracer distribution. No metabolically active lesions were noted.
Mild free fluid is seen in pelvis.
Brain parenchyma shows physiological tracer distribution. No metabolically active focal abnormal areas were noted.
No metabolically active lesions were seen in nasopharynx, oral cavity, oropharynx, larynx and hypopharynx.
Major salivary glands appear unremarkable. No metabolically active lesion was seen in the thyroid.
Both lungs are unremarkable. No metabolically inactive or metabolically active nodules or infiltrates were seen.
Trache and main stem bronchi appear unremarkable. There is no evidence of pleural effusion or metabolically active pleural abnormalities.
Gall bladder is visualised. No significant metabolically active abnormalities were seen in the gall bladder.
No metabolically active abnormality was seen in the pancreas.
Bilateral adrenals and right kidney are unremarkable and show physiological tracer distribution.
Stomach is not well distended. No metabolically active abnormality was seen in stomach bed.
Small and large bowel shows physiological tracer distribution.
Rectum shows physiological tracer distribution.
No significant metabolically active pelvic lymphadenopathy was noted.
Both axial and appendicular skeletal system shows physiological tracer distribution.
Urinary bladder is not well distended and shows physiological tracer distribution.

How is clep maths 1301 exam ?

My dad was recently diagnosed with cancer involving the liver. His CT report mentions multiple lesions in both lobes of the liver, enlarged lymph nodes, and metastasis. The biopsy confirmed cancer, but doctors still cannot identify the exact type or where it originated from, and we are currently waiting for the IHC report.

The local doctor told us that treatment options are limited to chemotherapy because it has already spread, and hearing that has completely devastated our family. My dad is only 50 years old and has worked incredibly hard his entire life, often 17 hours a day. Over a short period, he has lost nearly 20 kg, which has been heartbreaking to witness.

We are taking him to a larger cancer hospital for further evaluation and hoping for more answers and possible treatment options. Right now, I feel overwhelmed and scared. If anyone has experienced something similar, especially cases where the primary cancer was initially unknown or where patients responded well to treatment, I would truly appreciate hearing your stories or advice. We are holding onto hope while waiting for the IHC results.

( Normal in shape, size, attenuation & enhancement. Multiple heterogeneously enhancing lesions noted in both lobes of liver (more in left, largest measuring \~ 5.8x4.8 cm Hepatic veins and portal veins are normal. IHBR not dilated.) Left supraclavicular lymph node measuring \~ 27x14 mm.
Few subem left internal mammary lymph node noted
Few cardiophrenic lymph nodes noted, largest measuring \~ 19x11 mm.

IMPRESSION:
00.216 21
• Enlarged left supraclavicular lymph node.
• Few subem left internal mammary lymph node.
• Few cardiophrenic lymph nodes.
\> Multiple heterogeneously enhancing lesions noted in both lobes of liver - likely metastatic (D/D : multifocal HCC).
\* Mild pericholecystic fat stranding.
• Splenomegaly with Multiple splenorenal and splenogastric collaterals.
› Multiple aortocaval, paraaortic and periportal lymph nodes.
• Doubtful thickening in the region of cardia of stomach and GE junction. (Suggested upper Gl endoscopy to r/o gastric malignancy).
\> Minimal perihepatic fluid.
› Small size left kidney with prominent pelvicalyceal system with slightly more enhancing parenchyma than right side - ? d/t previous intervention/? infectiye.

My dad was recently diagnosed with cancer involving the liver. His CT report mentions multiple lesions in both lobes of the liver, enlarged lymph nodes, and metastasis. The biopsy confirmed cancer, but doctors still cannot identify the exact type or where it originated from, and we are currently waiting for the IHC report.

The local doctor told us that treatment options are limited to chemotherapy because it has already spread, and hearing that has completely devastated our family. My dad is only 50 years old and has worked incredibly hard his entire life, often 17 hours a day. Over a short period, he has lost nearly 20 kg, which has been heartbreaking to witness.

We are taking him to a larger cancer hospital for further evaluation and hoping for more answers and possible treatment options. Right now, I feel overwhelmed and scared. If anyone has experienced something similar, especially cases where the primary cancer was initially unknown or where patients responded well to treatment, I would truly appreciate hearing your stories or advice. We are holding onto hope while waiting for the IHC results.

( Normal in shape, size, attenuation & enhancement. Multiple heterogeneously enhancing lesions noted in both lobes of liver (more in left, largest measuring ~ 5.8x4.8 cm Hepatic veins and portal veins are normal. IHBR not dilated.) Left supraclavicular lymph node measuring ~ 27x14 mm.
Few subem left internal mammary lymph node noted
Few cardiophrenic lymph nodes noted, largest measuring ~ 19x11 mm.

IMPRESSION:
00.216 21
• Enlarged left supraclavicular lymph node.
• Few subem left internal mammary lymph node.
• Few cardiophrenic lymph nodes.
> Multiple heterogeneously enhancing lesions noted in both lobes of liver - likely metastatic (D/D : multifocal HCC).
* Mild pericholecystic fat stranding.
• Splenomegaly with Multiple splenorenal and splenogastric collaterals.
› Multiple aortocaval, paraaortic and periportal lymph nodes.
• Doubtful thickening in the region of cardia of stomach and GE junction. (Suggested upper Gl endoscopy to r/o gastric malignancy).
> Minimal perihepatic fluid.
› Small size left kidney with prominent pelvicalyceal system with slightly more enhancing parenchyma than right side - ? d/t previous intervention/? infectiye.