A case of rapidly progressing and poorly differentiated Ip‐type early‐stage colorectal adenocarcinoma. Issue 1 (26th October 2022)

• Record Type: Journal Article
• Authors: Tsubomoto, Atsuko; Sashiyama, Hiroshi; Koike, Junichi; Morita, Yohei; Tsutsumi, Osamu; Hamahata, Yukihiro
• Is Part Of: DEN open. Volume 3:Issue 1(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-10-26
• Subjects: early‐stage cancer -- implantation -- Ip‐type -- Ki67 antigen -- poorly differentiated colorectal adenocarcinoma; Gastrointestinal system -- Diseases -- Endoscopic surgery -- Periodicals; Gastroenterology -- Periodicals; 616.3307545
• DOI: 10.1002/deo2.181
• Languages: English
• ISSNs: 2692-4609

Abstract

Abstract: A 36‐year‐old woman visited our hospital with a chief complaint of bleeding during defecation. Colonoscopy revealed a 20‐mm pedunculated polyp in the sigmoid colon, which was en bloc resected under endoscopy. The histopathological diagnosis was adenoma cancer with a depth of invasion indicating mucosal cancer, no lymphovascular invasion, and negative at the resection margin. The poorly differentiated adenocarcinoma component comprised approximately 5% of the tumor. Although there were no recurrence signs in the computed tomography scans obtained 4 months post polypectomy, the patient experienced aggressive lower back pain at 6 months post polypectomy. Local recurrence, peritoneal dissemination, and liver metastasis were confirmed. Finally, the patient died following a rapid and aggressive deterioration of her general condition. Histological examination of the local recurrence revealed a poorly differentiated adenocarcinoma (por2), with immunostaining revealing a high Ki67 positivity rate of 95%. Moreover, the poorly differentiated adenocarcinoma region of the resected polyp had a Ki67 positivity rate of 90%, which suggested that they were the same tumors. These findings suggested that the recurrence could have occurred through implantation.