{"title":"早期直肠癌内镜下粘膜下剥离后复发为肿瘤沉积。","authors":"Takaaki Yoshikawa, Momoko Iketani, Atsushi Yamauchi, Sonoka Katsuyama, Sota Nakagami, Kenshiro Hirohashi, Shujiro Yazumi","doi":"10.1007/s12328-025-02160-9","DOIUrl":null,"url":null,"abstract":"<p><p>We found a 15 mm, 0-IIa + IIc polyp in the rectosigmoid with colonoscopy (CS), and performed endoscopic submucosal dissection (ESD) for it. The histopathologic specimen revealed that it was well-differentiated adenocarcinoma, T1b (SM2, 2000 μm), Ly0, v0, BD1, pHM0, and pVM0. Despite the non-curative resection with SM-deep invasion, the patient chose careful follow-up with contrast-enhanced computed tomography and CS. A nodule was first detected on the left side just out of the lower rectum 3 and a half years after ESD. Since it enlarged gradually, we judged that it was local recurrence in form of lymph-node metastasis and performed additional surgery 5 years after ESD. Pathological findings disclosed that the nodule was local recurrence as a tumor deposit (TD). One year after TD resection, lung metastasis was additionally founded and was resected surgically. If ESD accomplishes complete resection for T1b colorectal cancer and deep submucosal invasion is the only factor of non-curative resection, follow-up may be chosen instead of additional surgical resection. However, careful follow-up should be considered, because recurrence including TD may happen several years after ESD.</p>","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"646-652"},"PeriodicalIF":0.9000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Recurrence as a tumor deposit after endoscopic submucosal dissection of early rectal cancer.\",\"authors\":\"Takaaki Yoshikawa, Momoko Iketani, Atsushi Yamauchi, Sonoka Katsuyama, Sota Nakagami, Kenshiro Hirohashi, Shujiro Yazumi\",\"doi\":\"10.1007/s12328-025-02160-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>We found a 15 mm, 0-IIa + IIc polyp in the rectosigmoid with colonoscopy (CS), and performed endoscopic submucosal dissection (ESD) for it. The histopathologic specimen revealed that it was well-differentiated adenocarcinoma, T1b (SM2, 2000 μm), Ly0, v0, BD1, pHM0, and pVM0. Despite the non-curative resection with SM-deep invasion, the patient chose careful follow-up with contrast-enhanced computed tomography and CS. A nodule was first detected on the left side just out of the lower rectum 3 and a half years after ESD. Since it enlarged gradually, we judged that it was local recurrence in form of lymph-node metastasis and performed additional surgery 5 years after ESD. Pathological findings disclosed that the nodule was local recurrence as a tumor deposit (TD). One year after TD resection, lung metastasis was additionally founded and was resected surgically. If ESD accomplishes complete resection for T1b colorectal cancer and deep submucosal invasion is the only factor of non-curative resection, follow-up may be chosen instead of additional surgical resection. However, careful follow-up should be considered, because recurrence including TD may happen several years after ESD.</p>\",\"PeriodicalId\":10364,\"journal\":{\"name\":\"Clinical Journal of Gastroenterology\",\"volume\":\" \",\"pages\":\"646-652\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Journal of Gastroenterology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12328-025-02160-9\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Journal of Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12328-025-02160-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/23 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Recurrence as a tumor deposit after endoscopic submucosal dissection of early rectal cancer.
We found a 15 mm, 0-IIa + IIc polyp in the rectosigmoid with colonoscopy (CS), and performed endoscopic submucosal dissection (ESD) for it. The histopathologic specimen revealed that it was well-differentiated adenocarcinoma, T1b (SM2, 2000 μm), Ly0, v0, BD1, pHM0, and pVM0. Despite the non-curative resection with SM-deep invasion, the patient chose careful follow-up with contrast-enhanced computed tomography and CS. A nodule was first detected on the left side just out of the lower rectum 3 and a half years after ESD. Since it enlarged gradually, we judged that it was local recurrence in form of lymph-node metastasis and performed additional surgery 5 years after ESD. Pathological findings disclosed that the nodule was local recurrence as a tumor deposit (TD). One year after TD resection, lung metastasis was additionally founded and was resected surgically. If ESD accomplishes complete resection for T1b colorectal cancer and deep submucosal invasion is the only factor of non-curative resection, follow-up may be chosen instead of additional surgical resection. However, careful follow-up should be considered, because recurrence including TD may happen several years after ESD.
期刊介绍:
The journal publishes Case Reports and Clinical Reviews on all aspects of the digestive tract, liver, biliary tract, and pancreas. Critical Case Reports that show originality or have educational implications for diagnosis and treatment are especially encouraged for submission. Personal reviews of clinical gastroenterology are also welcomed. The journal aims for quick publication of such critical Case Reports and Clinical Reviews.