A Colonic Invasive Carcinoma with Metaplastic Component and Dedifferentiation at the Invading Front, Report of a Case Yorimasa Yamamoto 1 , Kouichi Koizumi 2 1Department of Internal Medicine, Cancer Institute Hospital 2Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital Keyword: 大腸癌 , metaplastic polyp , 粘膜下隆起 , ESD , hyperplastic polyposis pp.1399-1405
Published Date 2004/9/25
DOI https://doi.org/10.11477/mf.1403100571
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 A60-year-old woman underwent colonoscopic examination for faecal occult blood. There were12polyps in her large intestine.

 A flat lesion25mmin diameter in the ascending colon was composed of two parts. Biopsy specimens demonstrate that the very flat part of the lesion is metaplastic polyp, and the protruded part of that is well-differentiated adenocarcinama.

 We performed endoscopical submucosal dissection in order to resect the lesion en bloc.

 The pathological diagnosis of the lesion was carcinoma in a metaplastic polyp. The carcinoma had invaded the submucosal layer to the depth of1,700μm. It was re-evaluated to moderate-to-poorly differentiated adenocarcinoma at the invading front. Ileocecal resection was perfomed and there was no residual carcinoma or lymphnode metastasis. In addition,3of11polyps endoscopically resected contained intramucosal carcinoma. This patient can be categorized as a case of hyperplastic polyposis.

 1) Department of Internal Medicine, Cancer Institute Hospital, Tokyo

 2) Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo

Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.


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