An Interesting Shape of Is+IIc Type Advanced Colon Carcinoma, Report of a Case Toshimi Iura 1 , Hiroshi Ootani 2 , Hiroyuki Kobayashi 3 , Tadafumi Fuchikami 1 , Takashige Tomiyasu 4 , Keisuke Oikawa 4 , Takayuki Matsumoto 5,6 1Department of Gastroenterology, White Cross Hospital, Fukuoka, Japan 2Division of Pathology, White Cross Hospital, Fukuoka, Japan 3Department of Gastroenterology, Fukuoka Sanno Hospital, Fukuoka, Japan 4Division of Surgery, White Cross Hospital, Fukuoka, Japan 5Department of Medicine and Clinical Science, Graduate school of Medical Sciences, Kyushu University, Fukuoka, Japan Keyword: 大腸癌 , 肉眼型 , 低分化腺癌 , 微小乳頭癌 , 間質反応 pp.239-246
Published Date 2014/2/25
DOI https://doi.org/10.11477/mf.1403114077
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 A man in his sixties underwent total colonoscopy for the diagnostic purpose of abdominal discomfort. Conventional colonoscopy revealed a Is+IIc type tumor in the sigmoid colon. Magnifying colonoscopy with the NBI(narrow band imaging)system showed irregular vessels and a non vascular area in the depressed lesion at the top of the tumor . Magnifying colonoscopy with crystal violet showed VN type pit pattern in the depressed lesion at the top of the tumor. Barium enema revealed obvious deformation in the lateral view. Based on these findings, this tumor was diagnosed as the deeply submucosal or more invasive carcinoma. We operated using laparoscopy-assisted sigmoidectomy. Histopathological examination revealed moderately differentiated adenocarcinoma with invasive micropapillary pattern, tub2(>por1>tub1), type 0-Is+IIc, 15×15×4mm, pSS, pN0(0/4), pStage II, med, INFb, ly1(D2-40), ly(+)(SM), v1(VB-HE), v(+)(SM), pPM0(65mm), pDM0(32mm). The interesting shape of this tumor was molded by the desmoplastic reaction.

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