INTESTINE Vol.12 No.5(6)

Series
Title A case of submucosal invasive colon cancer occurring in hyperplastic polyp
Publish Date 2008/09
Author Toshio Uraoka Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Jun Kato Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Sakiko Hiraoka Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Keita Harada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Shin Ishikawa Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Motoaki Kuriyama Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Hideyuki Suzuki Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Syunsuke Saito Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Joichiro Horii Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Nobuya Ohara Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Author Kazuhide Yamamoto Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
[ Summary ] A 51-year-old man with a flat lesion in the descending colon was referred to our hospital for treatment of this lesion from a neighboring hospital. He had no family or past history associated with this condition. Colonoscopy revealed a flat lesion, 18 mm in diameter, consisting of reddish flat elevation and a slight central depression on the oral side, as well as a whitish slightly lower elevation on the anal side. Magnification views showed type VI (mild atypia) and II pit patterns on the surface of the oral and anal areas, respectively. We diagnosed This lesion was diagnosed as slight submucosal invasive cancer occurring in a hyperplastic polyp (HP). Then en bloc resection was performed by endoscopic submucosal resection. Histopathological diagnosis indicated well differentiated adenocarcinoma in an HP, pSM (250 Mum), lyO, vO, LM (-), VM (-). BRAF(V600E) mutation was detected in both cancerous areas, as well as and HP lesions.
This case could explain the development of these lesions from HP to invasive cancer via a serrated neoplastic pathway as observed through endoscopic findings with magnification. In addition, this was the first cancer in an HP case to be reported with a detailed analysis of histopathology and molecular biology.
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