It said he died of liver cancer. Although I didn't learn that until after we had already begun to reach into the abdomen. Already seen the lungs and looked inside the heart. Then we opened the envelope and saw written next to our table number only the barest facts: age at death, 71. Cause of death: metastatic liver cancer.
Certainly the liver was not in good shape. A healthy liver is smooth, arcing up to a point like a half paralleleogram. His liver was lumpy, it looked like a baseball was trying to break free of its surface. We noted it, studied briefly what the difference was, then put it aside with the bundle of intestines. Later, we were searching for the kidneys. What we found were adrenal tumors - two of them.
Your adrenal glands are supposed to be small, difficult to find, the size of your little finger. His were a golf ball and an egg. Hard and nobby. And tumors usually don't grow evenly, finding them in both sides of the body evenly on the same organs is unusual - and often a sign of other underlying causes like a genetic predisposition. Of course, none of us knew that at the time.
A few weeks later, a pathologist came to visit our lab. In an attempt to relate our basic science first year curriculum to our pathological patterns second year she comes and takes samples from interesting cases, which we were told we'd get to see in Histology in the spring when we'd learned what organs were supposed to look like under the microscope. At the time, she expressed a lot of surprise over the adrenal glands. She told us that liver cancer didn't usually go to the adrenal glands - especially not both of them! Maybe it was lung cancer that moved to both? See took samples of the lungs, the glands, the liver, the spleen. We, now also suspicious, waited through another month of anatomy, a month of neurology and a month and a half of histology.
To be continued. . . .
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