TWO CASES OF PEDUNCULATED SUBMUCOSAL (sm) COLON CANCER THAT UNDERWENT RAPID CHANGE

Abstract

We treated 2 patients with pedunculated submucosal (sm) colon cancer that underwent rapid change. Patient 1 was a 43-year old man. Colonoscopy was performed at our department and revealed a 20mm Ip polyp lobulation in the sigmoid colon. When colonoscopy was repeated about 1 month later, the head of the polyp had shrunk and the stem had become thicker and reddened. Endoscopic resection was performed and the diagnosis was moderately differentiated adenocarcinoma with invasion of the submucosa. Patient 2 was a 39-year old man. Barum enema was performed at the time of a health examination and revealed a 25mm lobulated polyp in the sigmoid colon. About 1 month later, Colonoscopy was performed at our department. The polyp had a 15mm spherical head and a thick stem. Repeat colonoscopy about 1 month later showed that the surface of the head was ulcerated and had changed to an umbrella shape. Endoscopic resection was performed and the diagnosis was moderately differentiated adenocarcinoma with invasion of the submucosa. It seems likely that Ip-type polyps had undergone transformation to cancer and invaded the submucosa, resulting in the rapid changes seen in both patients.