Sessile Serrated Adenoma/Polyp Developing into Early Colonic Carcinoma, Report of a Case Masayo Nishizono 1,2 , Hiro-o Yamano 1 , Taku Harada 3 , Kenjiro Yoshikawa 1 , Tomoaki Kimura 4 , Ryo Takagi 1 , Hiro-o Matsushita 1 , Eiji Harada 1 , Yoshihito Tanaka 1 , Michiko Nakaoka 1 , Yuko Yoshida 1 , Tamotsu Sugai 5 1Department of Digestive Disease Center, Akita Red Cross Hospital, Akita, Japan 2Department of Health Management, Sapporo-Kosei General Hospital, Sapporo, Japan 3Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan 4Sakoda Hospital, Miyazaki, Japan 5Department of Molecular Diagnostic Pathology, Iwate Medical University, School of Medicine, Morioka, Japan Keyword: 早期大腸癌 , SSA/P , 大腸鋸歯状病変 , 拡大内視鏡 pp.1731-1738
Published Date 2015/12/25
DOI https://doi.org/10.11477/mf.1403200497
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 A woman in her seventies was admitted to our department for the screening of colon cancer. Colonoscopy findings revealed a type IIa lesion, 7mm in diameter, in the ascending colon. The lesion was noted to have copious amounts of surface mucous. A chromoendoscopic view with an indigo carmine dye revealed type II open pit patterns over most of the lesion. On the basis of our findings, the lesion was diagnosed as a SSA/P(sessile serrated adenoma/polyp). We decided to closely monitor the patient mainly because of the presence of numerous other polyps in her colon. After 14 months, a repeat colonoscopy revealed significant changes to the lesion, which were noted to be type Is+IIa. Magnifying observation with crystal violet dyeing revealed type VI pit patterns over most of the lesion. On the basis of our findings, this lesion was diagnosed as an early colonic carcinoma that had invaded the mucosal layer. We treated this lesion using endoscopic mucosal resection. A histopathological examination revealed a papillary adenocarcinoma with SSA/P, Tis, ly0, and v0. It was thought that this lesion was an early colonic carcinoma that had developed from SSA/P.

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