INTESTINE Vol.12 No.1(2-6-1)

Theme Mesenchymal neoplasms of the colon and rectum : excluding lymphoproliferative disorders
Title Endoscopic diagnosis of colorectal cancer resembling submucosal tumors
Publish Date 2008/01
Author Mayuko Hirata Department of Endoscopy, Hiroshima University
Author Shinji Tanaka Department of Endoscopy, Hiroshima University
Author Shiro Oka Department of Endoscopy, Hiroshima University
Author Takayoshi Shishido Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University
Author Hiroyuki Kanao Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University
Author Iwao Kaneko Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University
Author Shigeto Yoshida Department of Endoscopy, Hiroshima University
Author Toru Hiyama Health Service Center, Hiroshima University
Author Yoshitaka Uneno Department of Endoscopy, Hiroshima University
Author Masanori Ito Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University
Author Yasuhiko Kitadai Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University
Author Masaharu Yoshihara Health Service Center, Hiroshima University
Author Kazuaki Chayama Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University
[ Summary ] Cases of colorectal cancer resembling submucosal tumors, most of which have surfaces covered with normal mucosa, are relatively rare. These lesions are very interesting in their development and progression. There have been several previous reports on these tumors. Most of these lesions display massive submucosal invasion or greater involvement. Therefore, accurate diagnosis and therapy are very important. In relation to differential diagnosis, normal submucosal tumors (lipoma, carcinoid, GIST, malignant lymphoma, etc.) as well as metastatic cancers may be observed.
When lesions are detected which resemble submucosal tumors seen in colorectal endoscopy, attention must be paid to the form, color and firmness of the tumor and the presence of depressions. Careful observation of pit patterns, as proposed by Kudo and Tsuruta et al, at the depression site with magnifying colonoscopy is very important for diagnosis. It is possible to type V pit patterns in colorectal cancer depressions.
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