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John O. Archambeau, M.D.
JAMA. 1958;167(17):2074-2076. doi:10.1001/jama.1958.72990340010007.
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A 56-year-old man was first hospitalized May 2, 1954, because of a change in his bowel habits and weight loss. His blood pressure was 150/80 mm. Hg, and his pulse rate 90 per minute. His heart sounds were of good quality, cardiomegaly was not noted, and the electrocardiogram (ECG) showed a left axis deviation with a minor intraventricular conduction defect. A roentgenogram of the chest was normal. A biopsy specimen was taken from a fungating tumor of the rectum which extended 4 to 14 cm. above the mucocutaneous junction. Histological examination revealed mucosecretory adenocarcinoma. A combined abdominoperineal resection was performed and examination of the specimen revealed metastases in 2 of 20 regional lymph nodes. After discharge he remained well for 18 months then was readmitted on Feb. 8, 1956, because of fracture of the right clavicle which contained a tumor mass measuring 9 by 6 by 6 cm. His blood


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