Abstract
This case involved a 76-year-old woman found to have occult blood in her stool. The patient underwent further testing in the form of lower gastrointestinal tract endoscopy, which revealed type Ip polyps in the descending colon. These were diagnosed as hyperplastic polyps, so a polypectomy was performed, but poorly differentiated adenocarcinoma and mucinous carcinoma were found in most of the resection specimens. Margins were positive, so further resection of the bowel was performed. Preoperative image findings also suggested para-aortic lymph node metastasis, therefore para-aortic lymph node dissection was also performed. Residual tumor cells were not found in the resected intestine but para-aortic lymph node metastasis was present, so the final diagnosis was adenocarcinoma, por2, muc>tub2 type 0-Ip, pSM (>5,000 μm), int, INFb, ly0, v1, M1 Stage IV. Characteristic endoscopic findings in this case indicated that lesions had invaded deep into the submucosa and had resulted in distal lymph node metastasis. The cross-sectional morphology of these lesions and their relationship to histological findings are described here, along with a discussion of some of the literature.
