INTESTINE Vol.22 No.5(10-2)

Theme Molecular biology of colorectal tumors
Title Case of colonic cancer of MSS phenotype occurring in sessile serrated adenoma/polyp
Publish Date 2018/09
Author Keisuke Kawasaki Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University,
Author Makoto Eizuka Department of Diagnostic Pathology, Iwate Medical University
Author Shunichi Yanai Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University
Author Kazuyuki Ishida Department of Diagnostic Pathology, Iwate Medical University
Author Masaki Endo Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University / Kaiunbashi Endoscopy Clinic
Author Shotaro Nakamura Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University
Author Tamotsu Sugai Department of Diagnostic Pathology, Iwate Medical University
Author Takayuki Matsumoto Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University
[ Summary ] A 43-year-old woman underwent a colonoscopy because of positive fecal occult blood findings. Colonoscopy revealed a sessile polypoid lesion with a central depression. Magnifying colonoscopic findings suggested a diagnosis of cancer in a sessile serrated adenoma/polyp (SSA/P). The patient was subsequently treated with endoscopic mucosal resection. Histological examinations exhibited moderately to well differentiated adenocarcinoma in the SSA/P with deep submucosal invasion. Molecular findings revealed that both SSA/P and cancer were positive for BRAF mutations and a high methylation epigenotype. However, an analysis of microsatellite stability revealed that both SSA/P and cancer were microsatellite stable. The patient was diagnosed as having colonic cancer with a MSS phenotype occurring with SSA/P.
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