Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
권호 표지

De Novo Submucosal Colorectal Cancer in a 3 mm Sessile Polyp

De Novo 점막하 침윤 대장암으로 진단된 3 mm 크기의 무경성 미소 용종

  • Koo, So-My (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Kim, Jin-Oh (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Kim, Hyun-Gun (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Lee, Tae-Hee (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Jeon, Seong-Ran (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Jin, So-Young (Institute for Digestive Research, Soonchunhyang University College of Medicine) ;
  • Lee, Joon-Seong (Institute for Digestive Research, Soonchunhyang University College of Medicine)
  • 구소미 (순천향대학교 의과대학, 소화기연구소) ;
  • 김진오 (순천향대학교 의과대학, 소화기연구소) ;
  • 김현건 (순천향대학교 의과대학, 소화기연구소) ;
  • 이태희 (순천향대학교 의과대학, 소화기연구소) ;
  • 전성란 (순천향대학교 의과대학, 소화기연구소) ;
  • 진소영 (순천향대학교 의과대학, 소화기연구소) ;
  • 이준성 (순천향대학교 의과대학, 소화기연구소)
  • Published : 2011.02.27
⟨ Previous Next ⟩

Abstract

The majority of colorectal carcinomas (95~100%) are thought to arise from adenomas. Yet colorectal carcinomas may rarely arise de novo. The popular definition of de novo carcinoma is that the lesion should consist exclusively of a carcinoma histologically and contain no adenomatous elements. Without an adenoma-carcinoma sequence, de novo carcinomas have a much higher rate of submucosal invasion, despite their small size. Their speed of growth is thought to be rapid. Some studies have shown that de novo carcinomas might arise as a macroscopically flat or depressed lesion, rather than a protruded one. However, the typical macroscopic findings of de novo carcinomas have not been established. They might be variable macroscopically and include a protruded type. We report a case of de novo colorectal carcinoma that invaded the submucosal layer involving a minute sessile polyp only 3 mm in diameter, which was removed by endoscopic mucosal resection.

대장암의 95~100%는 샘종-샘암종 과정을 거치며, 직접 발생 과정을 거친 de novo 대장암은 비교적 드물다. 일반적으로 de novo 대장암은 암조직 주변에 샘종이 동반되지 않는 경우로 정의되며, 샘종-샘암종의 단계가 생략되면서 샘종에서 기원한 암보다 상대적으로 더 빠르게 성장하며 침윤 정도도 더 깊을 수 있다. De novo 대장암은 평탄형이나 함몰형 육안 소견으로 보고되지만 아직까지 그 육안 소견이 정립되어 있지 않으며 융기형을 포함하여 다양한 형태로 관찰될 수 있다. 저자들은 내시경 점막절제술로 제거한 3 mm 크기의 무경성 미소 대장 용종의 병리 조직 검사에서 점막하층을 침범한 de novo 대장암을 진단하여서 이를 보고한다.

Keywords

References

  1. Vogelstein B, Fearon ER, Hamilton SR, et al. Genetic alterations during colorectal-tumor development. N Engl J Med 1988;319:525-532. https://doi.org/10.1056/NEJM198809013190901
  2. Shimoda T, Ikegami M, Fujisaki J, Matsui T, Aizawa S, Ishikawa E. Early colorectal carcinoma with special reference to its development de novo. Cancer 1989;64:1138-1146. https://doi.org/10.1002/1097-0142(19890901)64:5<1138::AID-CNCR2820640529>3.0.CO;2-A
  3. Stolte M, Bethke B. Colorectal mini-de novo carcinoma: a reality in Germany too. Endoscopy 1995;27:286-290. https://doi.org/10.1055/s-2007-1005694
  4. Bedenne L, Faivre J, Boutron MC, Piard F, Cauvin JM, Hillon P. Adenoma--carcinoma sequence or "de novo" carcinogenesis? A study of adenomatous remnants in a population-based series of large bowel cancers. Cancer 1992;69:883-888. https://doi.org/10.1002/1097-0142(19920215)69:4<883::AID-CNCR2820690408>3.0.CO;2-B
  5. Kudo S, Tamura S, Hirota S, et al. The problem of de novo colorectal carcinoma. Eur J Cancer 1995;31A:1118-1120.
  6. Kudo S, Tamure S, Nakajima T, et al. Depressed type of colorectal cancer. Endoscopy 1995;27:54-57. https://doi.org/10.1055/s-2007-1005633
  7. Kudo S, Kashida H, Tamura T, et al. Colonoscopic diagnosis and management of nonpolypoid early colorectal cancer. World J Surg 2000;24:1081-1090. https://doi.org/10.1007/s002680010154
  8. Iishi H, Tatsuta M, Tsutsui S, et al. Early depressed adenocarcinomas of the large intestine. Cancer 1992;69:2406-2410. https://doi.org/10.1002/1097-0142(19920515)69:10<2406::AID-CNCR2820691004>3.0.CO;2-E
  9. Kuramoto S, Mimura T, Yamasaki K, et al. Flat cancers do develop in the polyp-free large intestine. Dis Colon Rectum 1997;40:534-539. https://doi.org/10.1007/BF02055374
  10. Han D, Sohn JH, Cho YJ, et al. Flat depressed early colon cancer--a case report. J Korean Med Sci 1997;12:465-468. https://doi.org/10.3346/jkms.1997.12.5.465
  11. Kim HU, Kim YH, Song SY, et al. Characteristics of early colon cancer in Korea. Korean J Gastrointest Endosc 2004;29:126-132.
  12. Lee HS, Lee S, Seo JH, et al. Follow-up results of endoscopic mucosal resectios for early colorectal cancer. J Korean Soc Coloproctol 2006;22:103-112.
  13. Bedenne L. Populations and individuals at risk for colorectal cancer. Pathol Biol (Paris) 1992;39:902-903.