4 Kg Unintentional Weight in Surgery — 65yo Man | General Surgery | SMLE Q#11694

SMLE Question #11694

Surgery General Surgery

Objective: OBJ-TRACH-EMERG-01

Last updated: February 2026
A 65-year-old man has 4 months of alternating constipation and diarrhea, tenesmus, and intermittent blood-streaked stool with 4 kg unintentional weight loss. Physical examination, including digital rectal examination, is unremarkable. Rigid sigmoidoscopy shows a circumferential ulcerated mass in the distal sigmoid colon, and biopsies show adenocarcinoma. He has never undergone colorectal cancer screening. What is the most appropriate next step in management?

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