Ⅰp・Ⅰsp型大腸癌の深達度診断―通常内視鏡を中心として

Endoscopic Depth Diagnosis for Colon Submucosal Invasive Cancers with Pedunculated or, Sub-pedunculated Shape

要旨　Ⅰp型ないしはⅠsp型大腸sm癌の3例を呈示した．いずれの症例も容易に内視鏡的切除が可能であったが，全例sm癌で追加手術が必要となった．有茎性ないしは亜有茎性ポリープで，①頭部の大きさに近い太い茎を有するもの，②頭部が緊満感のあるもの，③頭部と茎部の境界が不明瞭であるもの，④頭部や頂部に陥凹やびらんがみられるものはsm癌を示唆する所見と考えられた．

　We encountered three patients with colon cancers invading the submucosa and assuming pedunculated or sub-pedunculated forms. These polyps were characterized by the following features. One was that they had thick stalks and swollen heads and, occasionally, a depression or an erosion on the top. Another was that the transition between the head and the stalk of the polyps could not be discerned clearly. We designated these shapes as having penis-like appearance. It was considered that these polyps grew up from cancers de novo and developed into pedunculated or sub-pedunculated shapes by mechanical irritation in the sigmoid colon. In conclusion, it is suggested that a polyp having a penis-like appearance should not be removed by endoscopic polypectomy.