[Solved]: CODE PCS The patient admitted to the hospital with…

CODE PCS The patient admitted to the hospital with significant weight loss associated with abnormal liver function tests. A CAT scan of the abdomen and pelvis noted a large mass in the tail of the pancreas and multiple hypodensities in the liver. He was seen in consultation and was subjected to a CAT scan–guided liver biopsy. He was also subjected to tumor markers that included a CEA and a CA19-9. He was noted to have markedly elevated CA19-9 at 2050. His CEA was 4.3 and his alfa-fetoprotein was less than 1.2. The CAT-guided liver biopsy noted a high-grade infiltrating adenocarcinoma that was CK-7 and CAM 5.2 positive. The hepar antigen was negative. Based on this immunohistochemical staining, he was noted to have a metastatic pancreatobiliary carcinoma. His staging workup with CAT scan of the chest noted nonspecific mediastinal and axillary lymphadenopathy. The bone scan was essentially negative for metastatic disease. The CAT scan of the pelvis noted an enlarged prostate with questionable inflammatory changes on the dome of the bladder. Based on this evaluation, he was diagnosed with metastatic pancreatobiliary carcinoma and metastatic disease to the peritoneal wall and the dome of the bladder. Following his diagnosis, he was referred to me and has been started on palliative chemotherapy with Gemzar. He has been tolerating Gemzar without much adverse effects. He was admitted to the hospital early this morning with uncontrolled blood sugars. The most likely etiology of his uncontrolled blood sugars is prednisone therapy.