Case History
Patient came with complaint of hard stools and difficulty in passing stools in
September 2020. Thereafter he took enema.
Post enema there was blood oozing from anus for which he went to Emergency.
Sept 2020: Came to Kanpur – Consulted Physician
Oct 2020: Advised Right Inguinal LN and punch Biopsy Ano-Rectal mass for HPE
Jan 2021: Biopsy done on 11.01.2021 suggestive of Metastatic poorly
differentiated Ca in Inguinal LN and Anorectal tissue – Moderate to High Grade
Epithelial Dysplasia with similar Island of Atypical poorly Differentiated Tumor
seen in stroma
? Cancer Anal Canal
Patient was then referred to TATA Memorial Hospital – (Branch in Varanasi)
No treatment was initiated due to 1.5 month long waiting period.
In March 2021: He met to Dr. Archita Gupta (M.D. Oncology) in Kanpur
There he took 3 cycles of Chemotherapy (March, April, May, June)
After further investigation of CECT Abdomen and Endoscopy, Dr. Archita Gupta advised him to go for RT
Then he went to J K Cancer Institute, Kanpur.
There he took 4 cycles of Chemo (Cisplatin 150 mg – Day1) (5FU 1 gm – Day1, Day3)
It was followed by 23 cycles of RT
In Sept 2022: Dr. S. K. Nigam operated when brought with complaint of burning micturition, prostate Grade-1
Post-Op (Excised Inguinal LN) Histopathology S/O metastatic poorly differentiated carcinoma.
On 25.11.2022, HRSG and colour Doppler Study of Inguinal scrotal region was done.
After that on 16.05.2023, Patient was advised to go to Higher Centre
Thereafter he was admitted under Dr. Manish Singhal for further evaluation with PET-CT scan dated 17.05.2023.
He was then started on Inj. Nivolumab 40 mg
Post 3 cycles, PET-CT was done 19.07.2023, in which there was significant response seen.
He received 4th cycle on 20.07.2023
Comparison PET-CT scan dated 19-07-2023
Comparison PET-CT scan dated 19-07-2023
