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Mucosal Spreading Depressed Type Colorectal Tumors: A Report of Two Cases
Author(s) -
TOGASHI Kazutomo,
KONISHI Fumio,
KOJIMA Masayuki,
ITABASHP Kunihiro,
KANAZAWA Kyotaro
Publication year - 1998
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.1443-1661.1998.tb00563.x
Subject(s) - medicine , atypia , submucosa , colonoscopy , tubular adenoma , adenoma , lumen (anatomy) , pathology , adenocarcinoma , colorectal cancer , gastroenterology , cancer
Superficial depressed type colorectal carcinomas usually show invasion into the submucosa while the tumor is small, measuring less than 10 mm in diameter. We experienced two rare cases of superficial depressed type colorectal tumors of more than 15 mm in diameter which only displayed intramucosal spread. These two lesions showed a clearly depressed appearance on colonoscopy and in the resected specimens, which were different from creeping tumors. One of the lesions was histologically diagnosed as being well differentiated adenocarcinoma without submucosal invasion, and the other was an adenoma with severe atypia. Both lesions had no Ki‐ras point mutation and this result was consistent with recent genetic studies on depressed type colorectal tumor. Based on these colonoscopic findings, a simple change in the quantity of air inside the lumen may effectively distinguish a depressed type tumor larger than 15 mm, which is limited to the mucosa, from one with submucosal invasion. Thus bowel resection can be avoided in such cases.