OHKI Takeshi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Case report
Language English
Peer review Non peer reviewed
Title Pedunculated early colorectal cancer with nodal metastasis: a case report.
Journal Formal name:World journal of surgical oncology
Abbreviation:World J Surg Oncol
ISSN code:14777819/14777819
Domestic / ForeginForegin
Volume, Issue, Page 19(1),pp.269
Author and coauthor 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
Publication date 2021/09
Summary 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