Rectal Cancer with Unusual Growth, Report of a Case S. Miyazaki 1 , T. Mukada 1 , K. Itasaka 1 , J. Kashiwagura 1 , H. Igura 2 1Department of Internal Medicine, Yamagata City Hospital Saiseikan 2Department of Surgery, Yamagata City Hospital Saiseikan pp.89-93
Published Date 1984/1/25
DOI https://doi.org/10.11477/mf.1403106938
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 The patient, a 42 year-old woman, visited our hospital with a chief complaint of bloody stools. Barium enema examination showed in the rectosigmoid colon a protuberant lesion and slight stricture in its neighborhood. Colonofiberscopic examination revealed in the same place edematous change of the wall and poor distension. At a place 17 cm oral from the anal ring was seen a protruding lesion strictured at the base with central depression. Histological study of the biopsy specimens showed adenocarcinoma, but otherwise no malignant finding was seen in the adjacent edematous mucosa.

 The rectosigmoid mucosa of the resected specimen was edematous with a tumor mass formation, measuring 15×10 mm. Underneath the protrusion was seen another tumor far bigger than a hen egg. Histologically the mucosa was highly edematous and the tumor seen in the mucosa was a mass of well-differentiated adenocarcinoma with no vestige of adenoma. Cancer infiltrated vertically along the lymphatic vessels from the submucosa to muscle layer. As it reached deeper from the muscle layer to serosa poorly differentiated cancer cells became more dominant. In some parts were seen structures suggesting traces of lymph nodes. Metastasis was seen in two regional lymph nodes, but at the time of operation other organs were not involved. The present case was advanced colon cancer showing small growth in the mucosa but unusual development forming an extramurally large tumor.

 Histogenesis of colon cancer has often been discussed such as adenoma-carcinoma sequence and de novo cancer. The present case seemed to suggest the latter.

Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.


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