The Wagging Tongue of a Sigmoid Cancer

Abstract

The patient’s prior medical history included hypertension, a myocardial infarct, and diabetes. For 1 year, frequent episodes of diarrhea had been present. For 3 months, she complained of lower abdominal pain, worse after meals, abdominal distention, audible bowel sounds, anorexia, and loss of weight. A barium enema examination demonstrated a large lesion of the distal sigmoid colon. On examination, there was abdominal distention and an irregular, immobile pelvic mass. Sigmoidoscopy revealed a polypoid tumor of the rectum at 10 cm. Biopsy confirmed the lesion to be a moderately well differentiated adenocarcinoma.