Stomach and Intestine(Tokyo) Volume 53, Issue 13 (December 2018)
Japanese

Flat and Depressed Type Intramucosal Carcinoma in the Rectum with Challenging Invasion Depth Diagnosis Because of Inverted Muscularis Mucosae, Report of a Case Takahiro Sasaki 1 , Yusuke Saitoh 1 , Masaki Taruishi 1 , Ryuji Sugiyama 1 , Ryuji Sukegawa 1 , Yuhei Inaba 1 , Kenichiro Ozawa 1 , Akio Takada 2 1Digestive Disease Center, Asahikawa City Hospital, Asahikawa, Japan 2Division of Pathology, Asahikawa City Hospital, Asahikawa, Japan Keyword: 早期大腸癌 , 内反 , 形態変化 , EUS pp.1800-1807
Published Date 2018/12/25
DOI https://doi.org/10.11477/mf.1403201546
  • Abstract
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 In a male patient in his sixties, a 5-mm submucosal tumor-like lesion with reddish central protrusion was detected on colonoscopy. The 10-month follow-up colonoscopy revealed that the lesion size remained unchanged, but its shape changed to a flat elevated lesion with a central depression. Endoscopic ultrasonography revealed that hypoechoic tumor invaded the submucosal layer with 3,000-μm invasion distance, and the submucosal space was visualized between the tumor invasion front and proper muscle layer. However, the preoperative diagnosis was submucosal invasive cancer with moderate amount ; the lesion was small, and the submucosal space was visualized between the tumor invasion front and proper muscle layer by EUS. In addition, endoscopic submucosal dissection was performed, and en-block resection with negative vertical margin was accomplished. Histopathological specimens revealed well-differentiated intramucosal carcinoma(Tis)ly0, v0, HM(−), VM(−)mimicking submucosal(T1)carcinoma because of inverted muscularis mucosae into the submucosal layer.


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基本情報

05362180.53.13.jpg
胃と腸
53巻13号 (2018年12月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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