A 53-year-old woman has noticed increasing malaise. On physical examination, there are no abnormal findings, but a stool guaiac test is positive. Her hemoglobin level is 7.9 g/dL. A colonoscopy is performed, and a 3-cm sessile mass is found in the cecum. A biopsy specimen of the mass shows a moderately differentiated adenocarcinoma confined to the mucosa. An abdominal CT scan shows no lymphadenopathy or hepatic lesions. Given this information, which of the following is the best course of action?

**Core Concept**
The patient has a 3-cm sessile mass in the cecum with a biopsy diagnosis of moderately differentiated adenocarcinoma confined to the mucosa, indicating early-stage colorectal cancer. The clinical challenge is to determine the optimal management strategy for this patient.

**Why the Correct Answer is Right**
Given the characteristics of the tumor (moderately differentiated, confined to the mucosa, and 3 cm in size), the patient is a candidate for endoscopic resection. This approach is preferred for early-stage colorectal cancers, as it preserves the integrity of the bowel wall and avoids the need for surgical resection. The absence of lymphadenopathy or hepatic lesions on the abdominal CT scan further supports this approach, as it suggests that the cancer has not metastasized.

* Endoscopic resection, such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), is a minimally invasive technique that allows for the removal of the tumor with a high degree of accuracy.
* This approach is particularly useful for small, superficial tumors like the one described in this case.
* The goal of endoscopic resection is to remove the tumor completely, with no residual disease left behind.

**Why Each Wrong Option is Incorrect**
**Option A:** Surgical resection would be more invasive than necessary for a tumor of this size and stage, and may not provide any additional benefit over endoscopic resection.

**Option B:** Chemotherapy is typically reserved for more advanced stages of colorectal cancer, where the tumor has metastasized or is at high risk of recurrence. In this case, the tumor is small and confined to the mucosa, making chemotherapy unnecessary.

**Option C:** Radiation therapy is also typically reserved for more advanced stages of colorectal cancer, and is not indicated for a tumor of this size and stage.

**Option D:** This option is incomplete, so we cannot comment on it.

**Clinical Pearl / High-Yield Fact**
For early-stage colorectal cancers, endoscopic resection is a safe and effective treatment option that preserves bowel function and avoids the need for surgical resection. This approach should be considered for patients with small, superficial tumors like the one described in this case.

**Correct Answer: C.**

✓ Correct Answer: D. Resect the tumor and some normal surrounding tissue