| 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 |
| 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. |