Extensive Recurrence of Colon Carcinoma

A 61-year-old man had a B2 adenocarcinoma of the sigmoid colon resected 2 years ago. He fainted, and on admission he was found to have a hemoglobin level of 5 g/dl. Colonoscopy showed a recurrent lesion at 12 cm. Computed tomography (CT) scan showed hydronephrosis of bilateral pelvic kidneys. Liver metastases, ascites and bilateral pleural effusions were also present. His creatinine level was 4.2mg/dl.