Open AccessDiagnosis of a submucosal mass at the staple line after sigmoid colon cancer resection by endoscopic cutting-mucosa biopsy
Author(s) -
Mitsuaki Morimoto,
Koji Koinuma,
Alan Kawarai Lefor,
Hisanaga Horie,
Homare Ito,
Naohiro Sata,
Yoshikazu Hayashi,
Keijiro Sunada,
Hironori Yamamoto
Publication year - 2016
Publication title -
world journal of gastrointestinal endoscopy
Language(s) - English
Resource type - Journals
ISSN - 1948-5190
DOI - 10.4253/wjge.v8.i8.374
Subject(s) - medicine , colonoscopy , endoscopic mucosal resection , biopsy , sigmoid colon , endoscopic ultrasound , surgery , radiology , colorectal cancer , lesion , endoscope , endoscopy , cancer , rectum
A 48-year-old man underwent laparoscopic sigmoid colon resection for cancer and surveillance colonoscopy was performed annually thereafter. Five years after the resection, a submucosal mass was found at the anastomotic staple line, 15 cm from the anal verge. Computed tomography scan and endoscopic ultrasound were not consistent with tumor recurrence. Endoscopic mucosa biopsy was performed to obtain a definitive diagnosis. Mucosal incision over the lesion with the cutting needle knife technique revealed a creamy white material, which was completely removed. Histologic examination showed fibrotic tissue without caseous necrosis or tumor cells. No bacteria, including mycobacterium, were found on culture. The patient remains free of recurrence at five years since the resection. Endoscopic biopsy with a cutting mucosal incision is an important technique for evaluation of submucosal lesions after rectal resection.