Abstract
Arare case of early ileal cancer discovered during colonoscopy is reported, In a 68-year-old man, irregular nodules through the ileocecal valve were detected during a colonoscopic examination that was performed to monitor recurrence of colonic intramucosalcancer treated by endoscopic mucosal resection. Because this tumor consisted of.irregularnodules with easy bleeding and-broad-based form, it appeared to be a submucosaLlyinvasive cancer. The endoscopic diagnosis was confirmed by histological examination ofbiopsy specimens, which showed a weld-differentiated adenocarcinoma. The tumor (size: 2.8 × 2.3 × 1.6cm), located in the ileum 2 cm proximal to the ileocecal valve, was surgicallyresected. Detailed histological examination of the resected tissue showed that the welldifferentiated adenocarcinoma was located mainly in the mucosal layer with the invasioninto suhmucosal layer at the top of the tumor. No invasion into veins or lymph vessels was observed.
Early ileal cancer has been rarely reported, with only 6 cases in the Japanese and English literatures until Sept, 1994. In the present case, the criteria of colonoscopic examination on an elevated type of early colorectal cancer were useful for evaluating theextent of invasion of the tumor. Since 29-40 % of ileal cancers develop in the ileum within 10cm from the ileocecal valve according to the Japanese literature, observation of theterminal iieum during colonoscopic examination is useful for detecting early ileal cancers.
