scholarly journals Early Pedunculated Colorectal Cancer with Nodal Metastasis: A Case Report

2021 ◽  
Author(s):  
Hiroka Kondo ◽  
Shimpei Ogawa ◽  
Takeshi Ohki ◽  
Yoshiko Bamba ◽  
Yuka Kaneko ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Endoscopic Resection ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Lymphatic Invasion ◽  
Nodal Metastasis ◽  
Fecal Occult Blood ◽  
Poorly Differentiated Adenocarcinoma ◽  
Additional Surgery ◽  
Poorly Differentiated

Abstract Background: Among early colorectal cancers, pedunculated polyps have a higher complete resection rate than non-pedunculated cases and rarely require additional surgery. However, this time, we experienced a case of pedunculated colorectal cancer, which was histologically poorly differentiated adenocarcinoma. Lymphatic invasion was also found, so additional intestinal resection was performed and nodal metastasis was found.Case presentation: A 43-year-old woman underwent colonoscopy because of positive fecal occult blood. A 20 mm-sized pedunculated polyp was found in the descending colon, and endoscopic resection was performed. Histopathological examination revealed non-solid poorly differentiated adenocarcinoma, invading to the submucosa (3,500 μm from the muscularis mucosae) with lymphatic invasion. In spite of its early stage cancer, the risk of nodal metastasis was considered to be high, and bowel resection was additionally performed. Although there was no residual cancer in the site after endoscopic resection, a metastasis was found in one regional lymph node. The patient is undergoing postoperative adjuvant chemotherapy. There was no evidence of recurrence after three months after the additional surgery. Conclusions:　 For pedunculated polyps, additional bowel resection was performed for patients with multiple risk factors for nodal metastasis such as poorly differentiated adenocarcinoma and positive lymphatic invasion. Then, we experienced a case of nodal metastasis, so we report it with a review of the literature.

scholarly journals Pedunculated early colorectal cancer with nodal metastasis: a case report

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hiroka Kondo ◽  
Shimpei Ogawa ◽  
Takeshi Ohki ◽  
Yoshiko Bamba ◽  
Yuka Kaneko ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Endoscopic Resection ◽  
Bowel Resection ◽  
Lymphatic Invasion ◽  
Nodal Metastasis ◽  
Early Colorectal Cancer ◽  
Muscularis Mucosa ◽  
Poorly Differentiated Adenocarcinoma ◽  
Additional Surgery ◽  
Poorly Differentiated

Abstract 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.

scholarly journals Five-Year Survival after Surgery for Invasive Micropapillary Carcinoma of the Stomach

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Shigeo Ninomiya ◽  
Kazuya Sonoda ◽  
Hidefumi Shiroshita ◽  
Toshio Bandoh ◽  
Tsuyoshi Arita
Keyword(s):  
Lymphatic Invasion ◽  
Nodal Metastasis ◽  
Upper Gastrointestinal Endoscopy ◽  
Invasive Micropapillary Carcinoma ◽  
Micropapillary Carcinoma ◽  
Poorly Differentiated Adenocarcinoma ◽  
Poorly Differentiated ◽  
Upper Abdominal ◽  
Micropapillary Component ◽  
Upper Gastrointestinal

Invasive micropapillary carcinoma (IMPC) of the breast, urinary bladder, ovary, and colon has been reported. However, few reports have described IMPC of the stomach. In addition, IMPC has been described as a histological indicator for lymphatic invasion and nodal metastasis, resulting in poor prognosis. We report a case of 5-year survival after surgery for IPMC of the stomach. A 69-year-old woman was admitted to our hospital with symptoms of upper abdominal pain. Upper gastrointestinal endoscopy revealed a tumor at the antrum of the stomach. Histological examination of the biopsy specimen indicated poorly differentiated adenocarcinoma. The patient underwent distal gastrectomy with lymph node dissection. Microscopic examination of the specimen revealed that the tumor consisted of an invasive micropapillary component. Carcinoma cell clusters were floating in the clear spaces. The patient recovered uneventfully and remains alive without recurrence 5 years after surgery.

Correction: Artificial intelligence may help in predicting the need for additional surgery after endoscopic resection of T1 colorectal cancer

Endoscopy ◽  
2018 ◽  
Vol 50 (03) ◽  
pp. C2-C2 ◽  
Author(s):  
Katsuro Ichimasa ◽  
Shin-ei Kudo ◽  
Yuichi Mori ◽  
Masashi Misawa ◽  
Shingo Matsudaira ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Colorectal Cancer ◽  
Endoscopic Resection ◽  
Additional Surgery ◽  
T1 Colorectal Cancer

scholarly journals Association of Poor Differentiation or Positive Vertical Margin with Residual Disease in Patients with Subsequent Colectomy after Complete Macroscopic Endoscopic Resection of Early Colorectal Cancer

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Ki Ju Kim ◽  
Hyun Seok Lee ◽  
Seong Woo Jeon ◽  
Sun Jin ◽  
Sang Won Lee
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Endoscopic Resection ◽  
Resection Margin ◽  
Residual Disease ◽  
Early Colorectal Cancer ◽  
Residual Cancer ◽  
Mucinous Histology ◽  
Poor Differentiation ◽  
Poorly Differentiated

In the presence of unfavorable pathologic results after endoscopic resection of colorectal cancer, colectomy is routinely performed. We determined the risk factors for residual diseases in patients with colectomy after complete macroscopic endoscopic resection of early colorectal cancer. We identified consecutive patients who underwent endoscopic resection of early colorectal cancer and subsequently underwent colectomy, from January 2011 to December 2014. Clinicopathologic risk factors related to the residual disease were analyzed. In total, 148 patients underwent endoscopic resection and subsequent colectomy. Residual disease on colectomy was noted in 16 (10.9%) patients. The rates of poorly differentiated/mucinous histology (p=0.028) and of positive or unknown vertical resection margin (p=0.047) were higher in patients with residual disease than in those without. In multivariate analysis, a poorly differentiated/mucinous histology and positive or unknown vertical resection margin were significantly associated with residual disease (odds ratio = 7.508 and 2.048, p=0.015 and 0.049, resp.). After complete macroscopic endoscopic resection of early colorectal cancer, there is a greater need for additional colectomy in cases with a positive or unknown vertical resection margin or a poorly differentiated/mucinous histology, because of their higher risk of residual cancer and lymph node metastasis.

scholarly journals Analysis of Additional Surgery after Non-Curative Endoscopic Resection for cT1 Colorectal Cancer

2017 ◽  
Vol 70 (1) ◽  
pp. 9-13
Author(s):  
Tsuneyuki Uchida ◽  
Hiroyasu Kagawa ◽  
Yusuke Kinugasa ◽  
Akio Shiomi ◽  
Tomohiro Yamaguchi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Endoscopic Resection ◽  
Additional Surgery

scholarly journals Endoscopic resection of poorly differentiated adenocarcinoma arising from hyperplastic polyp

2013 ◽  
Vol 82 (1) ◽  
pp. 136-137
Author(s):  
Yasutaka Yamada ◽  
Shinya Sugimoto ◽  
Yuichi Morohoshi ◽  
Tsuyoshi Ito ◽  
Yuya Tsunoda ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Hyperplastic Polyp ◽  
Poorly Differentiated Adenocarcinoma ◽  
Poorly Differentiated

Morbidity and mortality following major large bowel resection for colorectal cancer detected by a population-based screening program

2020 ◽  
pp. 096914132095736
Author(s):  
Lawrence F Paszat ◽  
Rinku Sutradhar ◽  
Elyse Corn ◽  
Jin Luo ◽  
Nancy N Baxter ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Large Bowel ◽  
Bowel Resection ◽  
Screening Program ◽  
Occult Blood ◽  
Population Based ◽  
Fecal Occult Blood ◽  
Operative Complications ◽  
Large Bowel Resection ◽  
Post Operative Complications

Background and aims In 2008, Ontario initiated a population-based colorectal screening program using guaiac fecal occult blood testing. This work was undertaken to fill a major gap in knowledge by estimating serious post-operative complications and mortality following major large bowel resection of colorectal cancer detected by a population-based screening program. Methods We identified persons with a first positive fecal occult blood result between 2008 and 2016, at the age of 50–74 years, who underwent a colonoscopy within 6 months, and proceeded to major large bowel resection for colon cancer within 6 months or rectosigmoid/rectal cancer within 12 months, and identified an unscreened cohort of resected cases diagnosed during the same years at the age of 50–74 years. We identified serious postoperative complications and readmissions ≤30 days following resection, and postoperative mortality ≤30 days, and between 31 and 90 days among the screen-detected and the unscreened cohorts. Results Serious post-operative complications or readmissions within 30 days were observed among 1476/4999 (29.5%) cases in the screen-detected cohort, and among 3060/8848 (34.6%) unscreened cases. Mortality within 30 days was 43/4999 (0.9%) among the screen-detected cohort, and 208/8848 (2.4%) among the unscreened cohort. Among 30 day survivors, mortality between 31 and 90 days was 28/4956 (0.6%) and 111/8640 (1.3%), respectively. Conclusion Serious post-operative complications, readmissions, and mortality may be more common following major large bowel resection for colorectal cancer between the ages of 50 and 74 among unscreened compared to screen-detected cases.

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