イタバシ　ミチオ   Itabashi Michio   板橋　道朗    所属   医学部 医学科    職種   特任教授
論文種別	症例報告
言語種別	英語
査読の有無	査読なし
表題	Pedunculated early colorectal cancer with nodal metastasis: a case report.
掲載誌名	正式名：World journal of surgical oncology 略　 称：World J Surg Oncol ISSNコード：14777819/14777819
掲載区分	国外
巻・号・頁	19(1),pp.269
著者・共著者	KONDO Hiroka, OGAWA Shimpei, OHKI Takeshi, BAMBA Yoshiko, KANEKO Yuka, KOSHINO Kurodo, NAKAGAWA Ryosuke, TANI Kimitaka, MAEDA Fumi, AIHARA Hisako, TOKITOU Fumiaki, FUJIKAWA Shuji, YAMAMOTO Tomoko, NAGASHIMA Yoji, INOUE Yuji, ITABASHI Michio, YAMAGUCHI Shigeki
発行年月	2021/09
概要	BACKGROUND:Pedunculated polyps are more likely to be amenable to complete resection than non-pedunculated early colorectal cancers and rarely require additional surgery. We encountered a patient with a pedunculated early colorectal cancer that consisted of poorly differentiated adenocarcinoma with lymphatic invasion. We performed an additional bowel resection and found nodal metastasis.CASE PRESENTATION:A 43-year-old woman underwent colonoscopy after a positive fecal occult blood test. The colonoscopist found a 20-mm pedunculated polyp in the descending colon and performed endoscopic resection. Histopathologic examination revealed non-solid type poorly differentiated adenocarcinoma. The lesion invaded the submucosa (3500 μm from the muscularis mucosa) and demonstrated lymphatic invasion. In spite of the early stage of this cancer, the patient was considered at high risk for nodal metastasis. She was referred to our institution, where she underwent bowel resection. Although there was no residual cancer after her endoscopic resection, a metastatic lesion was found in one regional lymph node. The patient is undergoing postoperative adjuvant chemotherapy, and there has been no evidence of recurrence 3 months after the second surgery.CONCLUSIONS:Additional bowel resection is indicated for patients with pedunculated polyps and multiple risk factors for nodal metastasis, such as poorly differentiated adenocarcinoma and lymphatic invasion. We encountered just such a patient who did have a nodal metastasis; herein, we report her case history with a review of the literature.
DOI	10.1186/s12957-021-02382-4
PMID	34479591