| Theme |
Metastatic recurrence and prognosis after endoscopic treatment for early colorectal carcinoma |
| Title |
A case of rectal cancer where a local recurrence was detected four years after complete EMR |
| Author |
Hiro-o Yamano |
Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine / Gastroenterology Center, Akita Red Cross Hospital |
| Author |
Kenjiro Yoshikawa |
Gastroenterology Center, Akita Red Cross Hospital |
| Author |
Hiro-o Matsushita |
Gastroenterology Center, Akita Red Cross Hospital |
| Author |
Eiji Harada |
Gastroenterology Center, Akita Red Cross Hospital |
| Author |
Yuko Yoshida |
Gastroenterology Center, Akita Red Cross Hospital |
| Author |
Bunichiro Kato |
Gastroenterology Center, Akita Red Cross Hospital |
| Author |
Makoto Sasaki |
Gastroenterology Center, Akita Red Cross Hospital |
| Author |
Yoshihito Tanaka |
Gastroenterology Center, Akita Red Cross Hospital / Department of Pathology, Iwate Medical University School of Medicine |
| Author |
Makoto Eizuka |
Department of Pathology, Iwate Medical University School of Medicine |
| Author |
Noriyuki Uesugi |
Department of Pathology, Iwate Medical University School of Medicine |
| Author |
Tamotsu Sugai |
Department of Pathology, Iwate Medical University School of Medicine |
| [ Summary ] |
Here, we report on a 70-year-old male patient who previously had a positive result for screening fecal occult blood test. The subsequent colonoscopy had shown a flat lesion of 8 mm in diameter in the lower rectum, which at the time was diagnosed by magnifying endoscopy as early rectal cancer with mucosal or slight submucosal invasion. We had then performed an endoscopic mucosal resection (EMR) with complete removal of the lesion, and the respective pathological examination revealed adenocarcinoma (tub1 type) in adenoma slightly invading the submucosa.
However, after four years we detected a flat lesion located in the same area as the EMR scars. The lesion showed both hyperextended normal mucosa and small round-like epithelial defect, and a presumptive diagnosis of recurrent cancer after EMR was made. The patient underwent surgical treatment and the diagnosis of residual, recurrence cancer was confirmed pathologically. Recurrence after complete endoscopic treatment for rectal cancer is very rare. Herein, we discuss the mechanisms underlying its recurrence. |