DALM (Dysplasia Associated Lesion or Mass) Complicated with Submucosal Invasive Carcinoma in the Flat Mucosa in Ulcerative Colitis, Report of a Case Toshiaki Watandbe 1 , Keisuke Hata 1 , Shinsuke Kazama 1 , Tetsuichiro Muto 2 , Hirokazu Nagawa 1 1Department of Surgical Oncology, University of Tokyo Hospital 2Cancer Institute Hospital Keyword: 潰瘍性大腸炎 , dysplasia , DALM , 大腸癌 pp.999-1004
Published Date 2002/6/25
DOI https://doi.org/10.11477/mf.1403104498
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 A 65-year-old man underwent surgery because DALM was detected by surveillance colonoscopy. The patient was referred to the University of Tokyo Hospital in 1994 with a diagnosis of extensive ulcerative colitis, six year after the onset of the disease. Surveillance colonoscopy was started from 1995. In 1996, biopsy specimens from the polypoid lesion in the sigmoid colon revealed dysplasia, which was considered to be a DALM. Therefore, surgical resection of the large bowel was perfomed. At the patient's request, left colectomy was performed. Pathological examination of the surgical specimen revealed no invasive carcinoma in the lesion of DALM, but invasive carcinoma apart from DALM was observed. There was no venous or lymphatic invasion. No lymph node metastasis was observed either. The patient has had no recurrence during the five years since the operation. Neither has surveillance colonoscopy revealed dysplasia during the same period.

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