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Small Advanced Cancer of the Descending Colon, Retrospective Analysis of the X-ray Findings, Report of a Follow-up Case Toshiaki Misono 1 , Hiroto Nishimata 2 , Yoshito Nishimata 2 , Tohru Niihara 1 , Masato Otsuji 1 1The Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University 2Department of Internal Medicine, Nanpu Hospital Keyword: 表面型大腸癌 , 小さな大腸進行癌 , 経過観察 , 深達度診断 pp.213-218
Published Date 1995/2/25
DOI https://doi.org/10.11477/mf.1403105318
  • Abstract
  • Look Inside

 A 69-year-old woman, who underwent partial colectomy about 3 years before to resect an advanced cancer of the ascending colon, visited our hospital for follow-up examination of the colon. A flat elevated lesion with central depression was detected in the descending colon by colonoscopy and barium enema study. Preoperative diagnosis was an early cancer of type Ⅱa + Ⅱc with massive invasion but limited to the submucosa.

 Partial colectomy was performed again, and histological examination showed that the lesion was tubular adenocarcinoma without adenomatous components, deeply infiltrating the subserosa. The size of the cancer exposed to the colonic lumen measured approximately 6 × 3 mm.

 In the period between these operations, barium enema studies were performed twice. Seven months prior to this surgery, the patient had complained of an episode of bloody stool. Though it was overlooked at the time, a small round flat elevated shadow with central depression was clearly demonstrated on the x-ray pictures. The lesion on the x-ray pictures was about half the size of the lesion found in the final study.

 Moreover, a careful retrospective study enabled us to go back and see the same lesion as a small nodular shadow about 3 mm in diameter on the x-ray pictures taken 2.5 years before the final operation. These findings of follow-up barium enema studies suggest that this cancer developed rapidly in the late stage, but only slowly in the early stage.

 Detection of any small flat elevated lesion less than 5 mm in diameter can be regarded as a basis for early diagnosis of colon cancer.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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