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- Title
Flat-Elevated (de novo) Carcinoma of the Sigmoid Colon with a Pedunculated Muscularis propria Mimicking a Polypoid Carcinoma.
- Authors
Tamai, Osamu; Yamada, Mamoru; Matsumoto, Mitsuyuki; Shiraishi, Masayuki; Kusano, Toshiomi; Muto, Yoshihiro; Toda, Takayoshi
- Abstract
A small flat-elevated carcinoma with a pedunculated muscularis propria mimicking an early polypoid carcinoma in a 67-year-old woman is reported. The patient was referred with a diagnosis of polypoid carcinoma of the sigmoid colon. Barium enema revealed an angular polypoid tumor, and endoscopy showed a sessile, plateau-like tumor with a central depression. Endoscopic ultrasonography showed a semilunar tumor with penetration into the muscularis propria, which showed a tent-like elevation. In July 1994, sigmoidectomy with lymph node dissection was performed. Macroscopically, the tumor was 2 cm in size and plateau-like with a depression. Microscopically, the tumor exhibited a plateau-like lesion with an ulcerative change on the surface. The section through the mid-portion of the tumor showed a stalk-like elevation of the inner circular muscle layer with carcinoma infiltration. The lymph nodes were involved by carcinoma. The tumor was a well-differentiated adenocarcinoma with invasion of the muscularis propria and positive regional lymph node metastasis (stage IIIb). The postoperative course was uneventful, and the patient is free of recurrence one year after surgery. This pedunculated stalklike formation of the muscle layer with invasive foci may be produced by peristalsis similar to that of the stalk of polyps. Copyright © 1996 S. Karger AG, Basel
- Publication
Digestive Surgery, 1996, Vol 13, Issue 1, p59
- ISSN
0253-4886
- Publication type
Article
- DOI
10.1159/000172407