| Theme | Metastatic recurrence and prognosis after endoscopic treatment for early colorectal carcinoma | |
|---|---|---|
| Title | A case of rectal LST lesion diagnosed as intramucosal carcinoma with lymph node metastasis recurrence | |
| Publish Date | 2019/06 | |
| Author | Yuki Mitsuyoshi | Department of Gastroenterology, The Cancer Institute Hospital of JFCR |
| Author | Shoichi Saito | Department of Gastroenterology, The Cancer Institute Hospital of JFCR |
| Author | Teruhito Kishihara | Department of Gastroenterology, The Cancer Institute Hospital of JFCR |
| Author | Daisuke Ide | Department of Gastroenterology, The Cancer Institute Hospital of JFCR |
| Author | Akiko Chino | Department of Gastroenterology, The Cancer Institute Hospital of JFCR |
| Author | Masahiro Igarashi | Department of Gastroenterology, The Cancer Institute Hospital of JFCR |
| Author | Yoshiya Fujimoto | Department of Lower GI Surgery, The Cancer Institute Hospital of JFCR |
| Author | Hiroshi Kawachi | Department of Pathology, The Cancer Institute Hospital of JFCR |
| [ Summary ] | A colonoscopy was performed on a 76 year old female by blood clot analysis. We recognized a huge laterally spreading tumor (LST) about 15 cm in size from the rectum (Rb to Ra). Endoscopic submucosal dissection (ESD) was performed. The pathological diagnosis is the result of LST-G (granular), 150x100 mm, adenocarcinoma (tub 1-tub 2) with tubular adenoma with moderate-severe atypia, Tis(M), ly (-), v(-), HM0, VM0 Met. A CT scan in the 2nd year after surgery revealed an enlarged lymph node (7 mm) in the rectum. We diagnosed lymph node metastasis and performed a laparoscopic ultra-low anterior resection. In this case, the lesion is huge and cutting is performed at intervals of 5 mm. There was a possibility that SM infiltration site could not be cut out. We think that it is possible to avoid such a situation by using the stereoscopic microscope and confirming the pit pattern again.s. |
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