Early colon cancer within a diverticulum treated by magnifying chromoendoscopy and laparoscopy.

Abstract:

:We report a unique case of intramucosal carcinoma in a tubulovillous adenoma arising from a single diverticulum. Endoscopic mucosal resection (EMR) was carried out successfully and completely with the assistance of laparoscopy. A 71-year-old man was admitted to our hospital because of melena and anemia. Emergent colonoscopy showed diverticulosis in the right-sided colon. However, endoscopy could not exactly detect the bleeding site. A flat elevated polyp was found within a single diverticulum located in the descending colon and diagnosed as an intramucosal carcinoma, as magnifying chromoendoscopy revealed a type IV pit pattern. As his diverticular bleeding repeated, a right-sided hemicolectomy was decided for treatment, the polyp within the diverticulum was also completely removed by EMR with the assistance of laparoscopy. Although a colonic perforation was detected immediately after EMR, the perforation was closed with endoclips intraluminally and also repaired laparoscopically from the serosal side. Histologically, the resected lesion was an intramucosal well-differentiated adenocarcinoma and the surgical margin was free of tumor.

journal_name

World J Gastroenterol

authors

Fu KI,Hamahata Y,Tsujinaka Y

doi

10.3748/wjg.v16.i12.1545

subject

Has Abstract

pub_date

2010-03-28 00:00:00

pages

1545-7

issue

12

eissn

1007-9327

issn

2219-2840

journal_volume

16

pub_type

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