A CASE OF SIGMOID COLON CARCINOMA WITH INFLAMMATORY CHANGE AND DIFFUSE INFILTRATION

Abstract

A 58-year-old man with a complaint of narrowing stools was referred to our hospital. Barium enema and colonoscopy revealed a 10-cm-long annular stricture in the rectum extending to the sigmoid colon, and the tumor was almost entirely covered with normal mucosa. Under careful endoscopic observation, biopsy specimens were obtained from the area where the tumor showed surface exposure, and the histological diagnosis was well differentiated adenocarcinoma. Endoscopic ultrasonography revealed thickening of the second and third layers in the annular stricture and a low-echoic mass in the anal part of the lesion. High anterior rectal resection with D3 lymph node dissection was done. Histologically, the stenotic lesion was composed of well differentiated adenocarcinoma invading to the muscular layer and of severe inflammatory cell infiltration into the submucosal layer associated with abscess formation. The patient has remained disease-free for 13 months since surgery. Colon cancer with inflammatory stenosis is rare, and only 11 cases including the present one have been reported in Japan.