| Theme |
Proceedings of 13th Annual Meeting on Colorectal IIc Lesions |
| Title |
Three cases of submucosal cancer of the colon originating from depressed type |
| Author |
Tatsuo Hirano |
Center Building Clinic |
| Author |
Osamu Nawata |
Nawata Gastrointestinal Surgical Hospital |
| Author |
Takashi Nagae |
Department of Gastroenterology, Fukuoka University Chikushi Hospital |
| Author |
Yasuhiro Takaki |
Pathology, Fukuoka University Chikushi Hospital |
| Author |
Seiji Haraoka |
Pathology, Fukuoka University Chikushi Hospital |
| Author |
Akinori Iwashita |
Pathology, Fukuoka University Chikushi Hospital |
| [ Summary ] |
Three cases of submucosal cancer of the sigmoid colon originating from depressed type are reported. The tumor size ranged from 7 to 10 mm. At standard endoscopy in case 1, the lesion at a glance appeared polypoid with the depressed groove encircled by the normal mucosa (type Is+IIc). The lesions in cases 2 and 3 were typical of type IIa+IIc. Chromoendoscopy using indigo carmine filled the depressed grooves or a depressed area of the lesions surrounded by the normal mucosa. Magnifying endoscopy with crystal violet staining of the tumor surfaces demonstrated non-structural pit patterns (type VN) that highly suggest submucosal cancer invasions. Endoscopic ultrasonography confirmed the submucosal invasions. In case 3, a marked transformation of the tumor from type IIa+IIc to type Is+IIc was observed after 14 days. This tumor transformation in such a brief time is rare and may be attributed, not to the tumor growth but, to mechanical factors against the tumor. Microscopically, cancer invasions from the tumor surfaces in cases 1,2, and 3 were 1,150 Micro m, 2,250 Micro m and 2,600 Micro m, respectively. In all the three cases, lymphatic and/or venuolar permeations were observed. |