Morphological Features of Local Recurrent Adenomas and Carcinomas of the Colon and Rectum after Polypectomy Tsutomu Ishikawa 1 1Department of diagnostic Radiology, National Cancer Center Central Hospital Keyword: 大腸ポリペクトミー , 局所再発 pp.511-522
Published Date 1993/5/25
DOI https://doi.org/10.11477/mf.1403106163
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 We analyzed 10 local recurrent cases (11 lesions) of colorectal adenomas and/or carcinomas after polypectomy in our hospital during the last decade, and studied their macroscopic and histological features. Their histological findings at the initial polypectomy were adenomas; four lesions, cancers in adenoma; five lesions, and submucosal cancers; two lesions.

 As for macroscopical difference between the initial lesion and the recurrent one in the cases of adenoma and cancer in adenoma, three out of five type Ⅰp lesions were recognized as type Ⅰs, type Ⅱa and nodule-aggregating appearance at recurrence, and one type Ⅰs lesion as type Ⅱa, one nodule-aggregating lesion as a nodule. Accordingly, recurrent lesions were supposed to have a tendency to become short compared with their initial height before polypectomy. Also, converging folds and ulcer scars were considered to be characteristic as they were found in four out of the nine lesions.

 Histologically, two out of the four adenomas changed to cancers in adenoma, and four out of the five cancers in adenoma became adenomas at recurrence. Those which changed to submucosal invasive cancers and advanced cancers were not found among the nine lesions.

 In the two polypectomized cases of submucosal cancers, advanced cancers were found at the same site as the initial lesion on the six-month and seven-month follow-up examination. Endoscopically and radiographically, no abnormal finding was recognized on the mucosal surface until then. And in one case, lymph node metastasis adjacent to the polypectomy site was seen as a submucosal tumor.

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