2021 Volume 63 Issue 9 Pages 1609-1615
A 74-year-old woman who underwent colonoscopy was diagnosed with four laterally spreading tumors (LSTs) in the cecum and ascending and sigmoid colon, as well as type 1 and 2 cancers in the transverse colon. We performed endoscopic submucosal dissection (ESD) for all four LSTs and subsequent laparoscopic transverse colectomy for the transverse colon cancers. Colonoscopy performed one year later revealed newly developed type 2 cancer in the cecum and sigmoid colon at the site of the previous ESD. The patient denied a family history of colorectal cancer; therefore, recurrent colorectal cancer was attributed to tumor implantation and not hereditary colorectal cancer such as Lynch syndrome. We speculate that tumor implantation at the post-ESD ulcer site from any of the primary transverse colon cancers or LSTs could have led to cancer recurrence. To our knowledge, only a few cases of recurrent colon cancer secondary to post-ESD tumor implantation have been reported in the literature. Endoscopists who perform ESD for gastrointestinal cancers should consider the possibility of tumor cell implantation in patients with the aforementioned or similar clinical presentation.
