Recurrent advanced colonic cancer occurring 11 years after initial endoscopic piecemeal resection: a case report
| Autor: | Takeshi Nakajima, Takahisa Matsuda, Seiichiro Yamamoto, Hirokazu Taniguchi, Yutaka Saito, Takayoshi Kishino, Taku Sakamoto |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Colonoscopy Case Report Adenocarcinoma Lesion Humans Medicine lcsh:RC799-869 Lymph node Aged medicine.diagnostic_test business.industry General surgery Gastroenterology Cancer Sigmoid colon Endoscopy General Medicine medicine.disease Dissection medicine.anatomical_structure Colonic Neoplasms lcsh:Diseases of the digestive system. Gastroenterology Radiology Neoplasm Recurrence Local medicine.symptom business |
| Zdroj: | BMC Gastroenterology BMC Gastroenterology, Vol 10, Iss 1, p 87 (2010) |
| ISSN: | 1471-230X |
| Popis: | Background The high frequency of local recurrence occurring after endoscopic piecemeal resection (EPMR) for large colorectal tumors is a serious problem. However, almost all of these cases of local recurrence can be detected within 1 year and cured by additional endoscopic resection. We report a rare case of recurrent advanced colonic cancer diagnosed 11 years after initial EPMR treatment. Case presentation A 65-year-old male was diagnosed with a sigmoid colon lesion following a routine health check-up. Total colonoscopy revealed a 12 mm type 0-Is lesion in the sigmoid colon, which was diagnosed as an adenoma or intramucosal cancer and treated by EPMR in 1996. The post-resection defect was closed completely using metallic endoclips to avoid delayed bleeding. In 2007, at the third follow up, colonoscopy revealed a 20 mm submucosal tumor (SMT) like recurrence at the site of the previous EPMR. The recurrent lesion was treated by laparoscopic assisted sigmoidectomy with lymph node dissection. Conclusion When it is difficult to evaluate the depth and margins of resected tumors following EPMR, it is important that the defect is not closed in order to avoid tumor implantation, missing residual lesions and to enable earlier detection of recurrence. It is crucial that the optimal follow-up protocol for EPMR cases is clarified, particularly how often and for how long they should be followed. |
| Databáze: | OpenAIRE |
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