| Theme | Proceedings of 13th Annual Meeting on Colorectal IIc Lesions | |
|---|---|---|
| Title | Case report on 5 mm IIa+IIc lesion developing into 17 mm type 2 advanced cancer. Observations on morphological changes over eleven months (natural history) | |
| Publish Date | 2004/07 | |
| Author | Hiroko Serizawa | The Department of Gastroenterology, International Medical Center of Japan |
| Author | Yoshiro Tamegai | The Department of Gastroenterology, International Medical Center of Japan |
| Author | Yukio Saito | The Department of Surgery, International Medical Center of Japan |
| Author | Hideaki Yano | The Department of Surgery, International Medical Center of Japan |
| Author | Yuko Hiraga | The Department of Gastroenterology, International Medical Center of Japan |
| Author | Junichi Akiyama | The Department of Gastroenterology, International Medical Center of Japan |
| Author | Masatoshi Imamura | The Department of Gastroenterology, International Medical Center of Japan |
| Author | Shigeru Yamato | The Department of Gastroenterology, International Medical Center of Japan |
| Author | Naohiko Masaki | The Department of Gastroenterology, International Medical Center of Japan |
| Author | Naomi Uemura | The Department of Gastroenterology, International Medical Center of Japan |
| [ Summary ] | We experienced an interesting case which may help elucidate how superficial depressed tumors grow and explain their natural history. We present the case of a 72 year old male who was reffered to our hospital for further examination and treatment of a laterally spreading tumor of the ascending colon. In the first colonoscopy, a small IIa+IIc lesion, approximately 5 mm in diameter, was also observed in the descending colon. Ileocecal resection was performed for the LST, and EMR was planned to resect the small IIa+IIc lesion. However, EMR was not performed due to the patient's own circumstances. The second colonoscopy was performed eleven months later. At that time, the lesion appeared to be a type 2 advanced cancer, apporoximately 17 mm in diameter. With magnifying endoscopy, type VN pit pattern was observed, which indicated the tumor had invaded the submucosal layer massively. A left hemi colectomy was performed, the tumor was verified by pathological examination as a moderately differenciated adenocarcinoma, which had invaded the muscular layer. Tumor doubling time, which expresses the growth speed, was 2.07 months which was an unexpected result. |
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