Abstract
We report a case of early colonic cancer complicated by colonic adenomatous polyposis which was detected 4 years after surgery for colonic mucinous adenocarcinoma. The stage of disease and pattern of spread was determined to be IIa+IIc. The patient was a 32-year-old male. He was operated upon at the age of 28 for cancer of the ascending colon. The histological diagnosis was mucinous adenocarcinoma. The stage of disease was Borrman III. A surgical specimen revealed 2 intra-adenomatous cancer as well as more than 10 adenomatous polyps. A diagnosis of colonic adenomatous polyposis was made 6 months after operation. After the diagnosis, the colon was examined both endoscopically and radiographically every 6 months. During the follow-up period, by endoscopic polypectomy 3 adenomatous polyps were removed. An early colonic cancer (Type IIa+IIc) demonstrating penepration of the submucoosal layer was detecated at the hepatic flexure of the transverse colon at age 32. Partial resection of the transverce colon was performed. Histologically, the ha portion of the lesion was adenocarcinoma, with moderately to well differentiation; the IIc portion was consisted of signet ring cells. We first repoted the case of signet ring cell adenocarcinoma complicated by colonic adenomatous polyposis in Japan. This case is interesting, considering the process in which adenomatous polyps become malignant.
