Abstract
A woman in her 50s was diagnosed via colonoscopy as having a circumferential villous tumor from the rectosigmoid to the sigmoid colon. We considered the difficulty of treating the lesion with endoscopic submucosal dissection. We decided on surgery.About one and a half months later, preoperative colonoscopy performed to mark the lesion. The lesion had developed with the formation of nodular tissue resulted in narrowing of the colon lumen. Laparoscopic assisted sigmoidectomy and lymph node dissection were perfomed. The histological findings of the resected specimen revealed well differentiated adenocarcinoma in a villous adenoma invaded the submucosa with lymph node metastasis (size 70×65mm, IIa+Is, SM, ly0, v0, OW(-), AW(-), EW(-), lymph node metastasis : n1 ; 241(1/7), n2 ; 242(0/1), 251b(0/8), final stage IIIa). It was treated with UFT/UZEL (UFT 450mg/day, UZEL 75mg/day) orally for 6 months as postoperative chemotherapy. About one year after the operation, no evidence of recurrence has been noted. Recently, advances have been noted in the application of endoscopic diagnosis. In villous tumors such as in the present case, however, signs of malignant findings are not always revealed by endoscopy. The characteristic findings of villous tumor should be noted with reference to these cases.
