Morphological change of a laterally spreading rectal tumor over a short period

BMC Gastroenterology

Case Report

Yutaka Sasaki¹  Kuang-l Fu²  Yasuhiro Oono³  Tomonori Yano³  Kazuhiro Kaneko³  Hiroaki Ikematsu³  Takashi Kojima³  Hideaki Miyamoto⁴  Atsushi Ochiai⁵  Satoshi Fujii⁵ 

[1] Department of Gastroenterology and Hepatology, Faculty of Life Science, Kumamoto University, Kumamoto, Japan;Department of Gastroenterology, Juntendou University Nerima Hospital, Tokyo, Japan;Department of Gastroenterology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, 277-8577, Kashiwa City, Chiba, Japan;Department of Gastroenterology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, 277-8577, Kashiwa City, Chiba, Japan;Department of Gastroenterology and Hepatology, Faculty of Life Science, Kumamoto University, Kumamoto, Japan;Pathology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan;

关键词: Endoscopic Submucosal Dissection;    KRAS Mutation;    Tubular Adenoma;    KRAS Gene;    Flat Part;   

DOI  :  10.1186/1471-230X-13-129

 received in 2012-11-02, accepted in 2013-08-14,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundLaterally spreading tumors (LSTs) are generally defined as superficial lesions ≥10 mm in diameter that typically extend laterally rather than vertically along the colonic wall. LSTs are usually categorized into 2 subtypes: granular type and nongranular type. Large nodules or depressed areas in granular-type LSTs (LST-Gs) are endoscopic findings of a cancerous component and sometimes represent submucosal invasion. However, the lateral growth and development of LST-Gs remains unclear.Case presentationThis case report describes a case of 79-year-old woman who underwent total colonoscopy due to a positive fecal occult blood test and was detected a LST-G, about 30 mm in diameter in the lower rectum. The lesion consisted of not only aggregated small and large nodules typically seen in LST-Gs but also the hardly elevated flat parts. In the flat part, there were dilated round pits and no evident capillary vessels. Three months later, the flat part increased in height, the dilated round pits were partly replaced by type IIIL pits, and capillary vessels were evident. The lesion was removed by endoscopic submucosal dissection, and diagnosed pathologically as tubular adenoma. We performed the sequence analyses on KRAS, BRAF, NRAS and PIK3CA genes in flat part and nodular part separately, and a mutation of KRAS gene at codon 146 was observed at only nodular part, suggesting probable that nodular part be a precancerous lesion.ConclusionThis is a unique and suggestive case, providing information on progression of LST-Gs at the very early stage to carcinogenesis.

【 授权许可】

CC BY   
© Miyamoto et al.; licensee BioMed Central Ltd. 2013