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A Clinicopathological Study of IIa +IIc Type Early Colorectal Cancer with Massive Submucosal Invasion
Author(s) -
OKAMURA Shozo,
ASAI Toshio,
YAMAGUCHI Hatsuhiro,
HAMAJIMA Eiji,
KATOH Tadashi,
SHIMODAIRA Masaya,
ITOH Hisayoshi
Publication year - 1990
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/j.1443-1661.1990.tb00335.x
Subject(s) - medicine , barium enema , adenocarcinoma , lesion , colorectal cancer , colonoscopy , rectum , ascending colon , gastroenterology , sigmoid colon , pathological , pathology , asymptomatic , cancer
The authors investigated clinical data and pathological findings of eight cases of IIa + IIc type early colorectal cancer which showed minimal invasion in the mucosal laver, but massive invasion in the submucosal layer (deep invasion type). The average age of these 8 patients was 57.8 years (6 out of 8 cases were between 55 and 61‐years‐old). 6 patients were males; 2 were females. Five patients were asymptomatic with a positive reaction for fecal occult blood; the other 2 had anal bleeding. All but 1 patient were diagnosed as having the IIa+IIc type of cancerous lesion, by barium enema examination and colonoscopy. Five patients had lesions in the sigmoid colon, 2 had lesions in the rectum, and 1 had a lesion in the ascending colon. The maximum lesion diameters ranged from 5 to 25 mm, averaging 15.9 mm. Six lesions were less than 20 mm in maximum diameter; 3 of these were less than 10 mm. Pathologically, 5 cases were moderately differentiated adenocarcinoma, 2 were well differentiated adenocarcinoma, and one was poorly differentiated adenocarcinoma. None of the lesions had a coexisting adenomatous component. The incidence of lymph node metastasis was considerably higher than expected (2 out of 8 cases) for early invasive colorectal cancer. Our results suggest that the deep invasion type of early colorectal cancers (which probably arise de novo) are, though small as a rule, considered to have great potential to be malignant.