A 68-year-old woman presents with fatigue, pallor, and a palpable right lower quadrant mass. Hemoglobin is 7.8 g/dL with MCV 72 fL. Colonoscopy reveals a cauliflower-like growth in the cecum. Which statement best explains the clinical presentation of right-sided colon cancer compared to left-sided colon cancer?
- A Right-sided cancers often present with iron deficiency anemia due to occult bleeding and a palpable mass ✓
- B Right-sided cancers typically present earlier with obstructive symptoms due to solid stool
- C Left-sided cancers more commonly present with anemia due to the larger lumen
- D Right-sided cancers present with tenesmus and pencil-shaped stools
Correct answer: A. Right-sided cancers often present with iron deficiency anemia due to occult bleeding and a palpable mass
Explanation
Right colon cancers often present insidiously with iron deficiency anemia from occult bleeding, fatigue, and a palpable mass, as the right colon has a larger liquid-content lumen causing less obstruction. Left colon cancers present earlier with obstructive symptoms (change in bowel habit, pencil stools, tenesmus) due to smaller lumen and solid stool. This distinction is frequently tested.
Reference: Sabiston Textbook of Surgery, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.