Seeking expert opinion for a 62F with signet ring cell carcinoma of sigmoid colon diagnosed July 2025. She underwent surgery (LAR + hysterectomy + BSO) followed by chemotherapy (Dacotin + Capecitabine). Latest PET-CT Feb 2026 shows no liver, lung, brain metastasis and no residual primary lesion. However, there are FDG-avid peritoneal nodules (SUV ~7) with mild ascites, suggestive of post-op changes vs residual disease. Kindly advise on further management, chemotherapy strategy, CRS alone or CRS with HIPEC suitability or second line chemo.
Good evening Doctor.
I had intramucosal adenocarcinoma of the rectum about 9 years ago, arising from a tubulovillous adenoma (2 × 2 cm), moderately differentiated, with no invasion beyond the muscularis mucosa. Only polypectomy was done, and no further treatment was required. The report showed MSI negative / MMR proficient.
At that time MRI pelvis and CT scan were normal, and post-polypectomy site biopsy showed no dysplasia or malignancy.
Follow-up done regularly: • Colonoscopy – about 10 times, all normal (last on 12 November 2025)
• USG whole abdomen – 10 times, all normal
• Blood tests – about 6 times, normal
• Chest X-ray (PA) – 4 times, normal
Kindly advise the appropriate interval for future surveillance colonoscopy. Also, if a new polyp appears in future, would it necessarily be malignant in my case, or usually benign?
. Kindly send your advice by SMS when convenient. Thank you.
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