Colorectal metastasis within an adult male cadaver: case report and review of literature

INTRODUCTION: During a routine lab dissection, lesions were found to be scattered along the mesentery of the colon and small intestines, as well as the abdominal peritoneum. Due to its presentation and histological analysis, a diagnosis of adenocarcinoma was made. Adenocarcinomas are mucus-secreting cells that are found within and near the glands of organ (Nakhaie, Mohsen et al., 2020). One of the most common clinical manifestations of adenocarcinomas is within the colorectal region due to the numerous mucous secreting cells found within these sites. Literature reviews have indicated that different metastasis patterns that can differentiate between adenocarcinomas of various histological subtypes. OBJECTIVES: The primary objective of this study is to analyze the progress of metastasis of an adult male cadaver found in a routine academic dissection. METHODS: This study consists of a case study of an adult male cadaver and literature review regarding metastasis of colorectal adenocarcinomas. Histological slides were taken from the small intestine mesentery, ileocecal junction, liver, lungs, epidermis of the left lateral anterior neck, abdominal aorta and abdominal peritoneum. RESULTS: Current histological slides indicate the presence of adenocarcinoma within the abdominal peritoneum as well as the small intestine mesentery. Recent histological findings indicate that the primary tumor was located at the ileocecal junction and is consistent with an adenocarcinoma. Histological findings also show secondary metastasis to the liver. The lung nodule was found to be a fibrocalcific. Histological analysis of abdominal aorta was found to be atherosclerotic and thrombotic. The cyst on the epidermis of the neck was found to be benign. CONCLUSION: Research surrounding colorectal adenocarcinoma is still ongoing. We hope to establish the pattern of metastasis as well as the various organs that the adenocarcinoma metastasized to

Racial Discrepancies in Pulse Oximetry Reading and Their Effects on Self-monitoring Devices Usage and Clinical Decision-Making

INTRODUCTION: As technology use rises and the use of pulse oximetry data increases, the demand for accurate oxygen saturation (SpO2) readings is paramount to ensure health equity among all populations. Pulse oximetry is a non-invasive tool used to monitor SpO2. Self-monitoring devices, such as SMART devices, allow for portable and cost-effective utilization; therefore, self-monitoring device usage and pulse oximetry data are quickly becoming more available to patients and their providers. Pulse oximetry is a critical component used when evaluating the severity of arterial deoxygenation. Providers often use data from pulse oximetry to determine treatment options. Recent studies have found discrepancies in pulse oximeter reading among Black patients, posing a problem for both patients and their providers. We hypothesize that self-monitoring devices can affect mortality rates among Black patients if these disparities are not addressed. OBJECTIVES: The aim of this study is to investigate how racial discrepancies in pulse oximetry reading among self-monitoring devices can affect mortality rates among Black patients in the United States. METHODS: The design of this study is a systematic review and data extraction of relevant articles that discuss the use of self-monitoring devices to determine oxygen saturation and relevant racial disparities associated with health outcomes. RESULTS: Searches identified 123 citations with relative pulse oximetry data in relation to race. Some of the data extraction provided significant evidence that there are disparities present among reading provided by self-monitoring, pulse oximetry devices and Black patients. CONCLUSION This is a research proposal that is still ongoing. Current independent reviews of individual articles are still being analyzed

Cutaneous Nodule Associated with Colorectal Metastasis

During a routine cadaver thorax lab dissection of a 75 year-old Caucasian male, possible emphysema and neoplasms of cutaneous and pulmonary origin were discovered. Although rare, cutaneous metastasis of colorectal cancer occurs at 6.5% of all skin biopsies performed (Kemal et al, 2018). Pulmonary neoplasms are a common presentation for 10-22% of patients with colorectal cancer (Jung et al, 2015). Bilateral lobes were discovered to have necrotic, highly compliant lungs with a neoplasm of uncertainty found solely on the left medial superior lung lobe. Additionally, the cause of death of the cadaver was determined to be a combination of cardiopulmonary arrest, failure to thrive, and malignant neoplasm of the colon. Due to the cause of death, a neoplasm of uncertainty located on the left superior medial clavicle could be correlated. This flesh-colored nodule was measured to be, (insert length and height measurements here), which was firm and raised. We plan to take 8-10 histological slices as we continue to dissect the abdominal cavity and investigate the genitourinary system, which may have influence on these findings and present additional evidence of colorectal cancer metastasis. This additional evidence could help to provide further awareness for physicians treating patients with colorectal cancer of the potential for cutaneous and pulmonary metastasis (Kemal et al, 2018)

Sternalis Muscle: An Accessory Muscle

During a routine anatomy lab dissection, a group of first year medical students at Philadelphia College of Medicine (PCOM) South Georgia found an anatomic variant known as the sternalis muscle. This muscle was found bilateral and superficial to the left medial pectoral major muscle, with superior attachments to the sternum and inferior attachments to the left superior and lateral portion of the rectus abdominis. A past study found that 2% Caucasian, 8% African Americans, 11% Asian individuals had a sternalis muscle recorded as well as 8.7% women and 6.4% men of a 532 cadaver sample size (Bergman et al., 1992). Previous studies have shown that its presence can altered routine mammogram results which shows significance in misdiagnosis in breast cancer.

Sternalis Muscle- Anatomical Variation to Anterior Thorax

Introduction: During a routine cadaver dissection, an accessory muscle was found bilaterally and superficial to the pectoralis major. The sternalis muscle is an anatomical variation not commonly seen throughout the population. Its function, although unknown, is widely debated. Innervation variations were found in studies based on proximal/distal muscle attachments. Most were found to be innervated by either external or internal thoracic nerves (55%), while others were found to be innervated by intercostal nerves (43%). In a 532 cadaver study, it was found that this muscle was present in 11% of Asians, 8% in African Americans, and 2% in Caucasian individuals. More women (8.7%) than men (6.4%) were also found with this attachment. Objectives: The primary aim of this study is to provide further awareness to healthcare professionals of this anatomical variation as it can interfere with surgical procedures in addition to interfering with the accuracy of mammograms performed, which can increase the risk of breast cancer misdiagnosis. Methods: This study consists of a systematic literature review of sternalis muscle attachment findings, including its function, neurovascular variations, prevalence in the population, and embryologic origins. Results: The sternalis muscle was observed to attach proximally at the sternal notch and distally to the 10th and 11th rib . Conclusion: Due to the results, we postulate that the sternalis muscle is involved in flexion of the thorax and/or respiration although the extent of these functions is unclear. Research surrounding the sternalis muscle is still ongoing and further studies are needed to make conclusive statements regarding its function and embryological origins

Racial Disparities among Pulse Oximetry readings and Possible effects on COVID -19 outcomes

INTRODUCTION: During the height of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic, also known as COVID-19, clinicians warned the public of a significant symptom of COVID-19 called silent hypoxemia, where patients presented with low oxygen saturation levels and no dyspnea. Pulse oximetry is a critical component of evaluating the severity of arterial deoxygenation. However, studies have shown discrepancies in these readings amongst deep skin tone individuals or individuals with higher levels of active melanocytes. Data from recent studies have shown that black patients had almost three times the frequency of occult hypoxemia that was not detected by pulse oximetry. Due to the importance of pulse oximetry in medical decision-making, these findings may have some implications that may play a major role in COVID-19 health outcomes in marginalized communities. OBJECTIVE: The study\u27s primary objective is to bring awareness of pulse oximetry discrepancies and discuss the role and provide solutions that will reduce these discrepancies in COVID-19 health outcomes in marginalized communities. METHODS: The design of this study is a systematic review and data extraction of relevant articles that discuss pulse oximetry and racial disparities associated with pulse oximetry technology. RESULTS: Searches identified 21,431 citations with relative pulse oximetry accuracy and data related to COVID-19 health outcomes. Some data extractions provided significant evidence that the inaccuracy of these pulse oximetry readings resulted in late intubation and unnecessary intubations, which may have played an essential role in the increased mortality rate for black patients. CONCLUSION: This is a research proposal that is still ongoing. Current independent reviews of individual articles are still being analyzed