| Series | ||
|---|---|---|
| Title | Case of 13 mm IIa + IIc-like advanced rectal cancer | |
| Publish Date | 2012/11 | |
| Author | Takashi Murakami | Department of Gastroenterology, Juntendo University School of Medicine |
| Author | Naoto Sakamoto | Department of Gastroenterology, Juntendo University School of Medicine |
| Author | Kenshi Matsumoto | Department of Gastroenterology, Juntendo University School of Medicine |
| Author | Hiroya Ueyama | Department of Gastroenterology, Juntendo University School of Medicine |
| Author | Taro Osada | Department of Gastroenterology, Juntendo University School of Medicine |
| Author | Takashi Yao | Department of Human Pathology, Juntendo University School of Medicine |
| Author | Takeshi Terai | Terai Clinic |
| Author | Sumio Watanabe | Department of Gastroenterology, Juntendo University School of Medicine |
| [ Summary ] | We report on a case of a IIa + IIc-like lesion with reverse invasion. The subject was a sixty four year old female admitted to our hospital for treatment of a rectal tumor. Colonoscopy showed a flat elevated lesion in the rectum about 10 mm in size with a depressed area. The surface was irregular on the depressed area but covered with normal mucosa at the edge of the lesion. Magnifying endoscopy with narrow band imaging (NBI) demonstrated a type IIIB capillary pattern (CP) on the depressed area and CP type I at the edge of the lesion. The latter included an irregular round area with loose micro capillary vessels. This area had an irregular pit pattern, which indicated reverse invasion. After about one month the affected area had enlarged. In addition, several reverse invasion regions had fused. These findings suggested the lesion was submucosal massively or deeper invasive cancer. Therefore, laparoscopically assisted lower anterior resection was performed. Macroscopically, the lesion was observed to be 13 x 11 mm in size and classified as being IIa + IIc-like. Histological diagnosis was as follows : Ra，13 x 10mm，IIa + IIc like, moderately differentiated adenocarcinoma, pSS, ly0, v1. | |