Multidisciplinary approach of colorectal cancer and complicated diabetes

Grigorina Mitrofan (a), Roxana Adriana Stoica (b) (i), Cornelia Niţipir (c) (i), Georgiana Ditu (a), Răzvan Hainărosie (d)(i), Anca Pantea Stoian (e)(i), Cristinel Dumitru Badiu (f)(i), Silviu Piţuru (g)(i), Cristian Serafinceanu (h)(i)

a): MD, diabetes, nutrition and metabolic disease, National Institute of Diabetes, Nutrition and Metabolic Diseases “N C Paulescu”, Bucharest, Romania
b): MD, diabetes, nutrition and metabolic disease
c): MD, PhD, oncology, Elias University Emergency Hospital, Bucharest, Romania
d): MD, PhD, otorhinolaryngology, “Prof. Dr. D. Hociotă” Institute of Phonoaudiology and Functional ENT Surgery, Bucharest, Romania
e): MD, PhD, diabetes, nutrition and metabolic disease
f): MD, PhD, Department of Surgery “Bagdasar-Arseni” Clinical Emergency Hospital, Bucharest, Romania
g): MD, PhD, Professional Organization and Medical Legislation-Malpraxis
h): MD, PhD, professor, diabetes, nutrition and metabolic disease, National Institute of Diabetes, Nutrition and Metabolic Diseases “N C Paulescu”, Bucharest, Romania
i): University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

Abstract

The relationship between diabetes mellitus and rectal cancer is complex and often requires a multidisciplinary approach. In this case report, the management of an obese patient with 21 years of type 2 diabetes is described. He had a history of poor glycemic control (HbA1C=10.4%) with multiple microvascular (peripheral neuropathy) and macrovascular complications (carotid and aortic atherosclerosis). During his previous hospitalisation in the Nephrology Department of the National Institute of Diabetes and Metabolic Diseases “NC Paulescu” in Bucharest, Romania, based on low haemoglobin levels, a malignant rectal tumour was diagnosed through a positive Adler’s test and imagistic investigation (colonoscopy). Three month after surgery, he was admitted to the Nephrology department due to dyspnea, oliguria and nitrogen retention syndrome. This case-report aims to emphasise the importance of a multidisciplinary approach in the management of patients with both complicated diabetes and cancer.

Key words: diabetes, chronic kidney disease, colorectal cancer

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