Recurrent advanced colonic cancer occurring 11 years after initial endoscopic piecemeal resection: a case report

BMC Gastroenterology

Case Report

Hirokazu Taniguchi¹  Seiichiro Yamamoto²  Takayoshi Kishino³  Yutaka Saito³  Takahisa Matsuda³  Taku Sakamoto³  Takeshi Nakajima³ 

[1] Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan;Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan;Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan;

关键词: Adenoma;    Endoscopic Resection;    Endoscopic Mucosal Resection;    Faecal Occult Blood Test;    Recurrent Lesion;   

DOI  :  10.1186/1471-230X-10-87

 received in 2010-07-04, accepted in 2010-08-05,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe 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 presentationA 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.ConclusionWhen 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.

【 授权许可】

Unknown   
© Kishino et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.