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Invasive rectal cancer treated with a combination of endoscopic submucosal dissection and chemoradiation
Author(s) -
Fu Kuang I.,
Konuma Hironori,
Ueyama Hiroya,
Saga Taiji
Publication year - 2013
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12095
Subject(s) - medicine , chromoendoscopy , endoscopic submucosal dissection , rectum , colonoscopy , colorectal cancer , occult , radiology , fecal occult blood , lesion , dissection (medical) , carcinoma , surgery , cancer , pathology , alternative medicine
A 68‐year‐old man underwent total colonoscopy because of a positive fecal occult blood test. A polypoid lesion ( I s + IIa ), 20 mm in size, was detected in the very lower part of the rectum. A large reddish nodule suggesting invasive carcinoma was seen on conventional view. Magnifying chromoendoscopy, however, disclosed a non‐invasive pit pattern in that part. Moreover, magnifying narrow band imaging showed a type IIIA capillary pattern. Therefore, endoscopic submucosal dissection was successfully conducted for en bloc resection. Histologically, it was a rectal submucosal invasive carcinoma deeply invading into thesubmucosal layer with vascular invasion. Although additional surgical treatment was suggested, the patient refused the proposal and received chemoradiation therapy to avoid a permanent colostomy. Periodic evaluation revealed no local or distant metastasis 3 years thereafter.