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Open Access 01-12-2021 | Metastasis | Case report

Pedunculated early colorectal cancer with nodal metastasis: a case report

Authors: Hiroka Kondo, Shimpei Ogawa, Takeshi Ohki, Yoshiko Bamba, Yuka Kaneko, Kurodo Koshino, Ryosuke Nakagawa, Kimitaka Tani, Fumi Maeda, Hisako Aihara, Fumiaki Tokito, Shuji Fujikawa, Tomoko Yamamoto, Yoji Nagashima, Yuji Inoue, Michio Itabashi, Shigeki Yamaguchi

Published in: World Journal of Surgical Oncology | Issue 1/2021

Abstract

Background

Pedunculated polyps are more likely to be amenable to complete resection than non-pedunculated early colorectal cancers and rarely require additional surgery. We encountered a patient with a pedunculated early colorectal cancer that consisted of poorly differentiated adenocarcinoma with lymphatic invasion. We performed an additional bowel resection and found nodal metastasis.

Case presentation

A 43-year-old woman underwent colonoscopy after a positive fecal occult blood test. The colonoscopist found a 20-mm pedunculated polyp in the descending colon and performed endoscopic resection. Histopathologic examination revealed non-solid type poorly differentiated adenocarcinoma. The lesion invaded the submucosa (3500 μm from the muscularis mucosa) and demonstrated lymphatic invasion. In spite of the early stage of this cancer, the patient was considered at high risk for nodal metastasis. She was referred to our institution, where she underwent bowel resection. Although there was no residual cancer after her endoscopic resection, a metastatic lesion was found in one regional lymph node. The patient is undergoing postoperative adjuvant chemotherapy, and there has been no evidence of recurrence 3 months after the second surgery.

Conclusions

Additional bowel resection is indicated for patients with pedunculated polyps and multiple risk factors for nodal metastasis, such as poorly differentiated adenocarcinoma and lymphatic invasion. We encountered just such a patient who did have a nodal metastasis; herein, we report her case history with a review of the literature.

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Title: Pedunculated early colorectal cancer with nodal metastasis: a case report
Authors: Hiroka Kondo
Shimpei Ogawa
Takeshi Ohki
Yoshiko Bamba
Yuka Kaneko
Kurodo Koshino
Ryosuke Nakagawa
Kimitaka Tani
Fumi Maeda
Hisako Aihara
Fumiaki Tokito
Shuji Fujikawa
Tomoko Yamamoto
Yoji Nagashima
Yuji Inoue
Michio Itabashi
Shigeki Yamaguchi
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Metastasis
Colorectal Cancer
Colorectal Cancer
Published in: World Journal of Surgical Oncology / Issue 1/2021
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-021-02382-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pedunculated early colorectal cancer with nodal metastasis: a case report

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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