2010 Volume 46 Issue 7 Pages 1119-1124
A clinical case report of pediatric rectal cancer in Japan is extremely rare. The clinical medical strategy has not been sufficiently investigated. We report herein a case of rectal cancer which occurred in a 15-year-old girl. Family history was noncontributory. Physical and laboratory examinations for tumor markers were unremarkable. Some characteristics in the tumor came to be clear based on pit pattern categories via endoscopic views. The tumor proved to be a villous adenoma based on the histopathological evaluation of the biopsy at the initial endoscopic examination. However, the possibility of rectal mucosal cancer was strongly suggested from the information from the pit pattern via endoscopic views, barium enema, and CT scans. An endoscopic submucosal dissection (ESD) was performed based on the size, form, location, and invasive grade of tumor. Histopathological evaluation of the resected specimen diagnosed it as well differentiated adenocarcinoma. The surgical margin of the resected specimen was intact for both horizontal and vertical end tissue. Moreover, the resected specimen had no invasion to vessels or lymph ducts at all. The complete resection of the tumor was performed. It is a significant medical strategy to perform ESD for pediatric rectal cancer in the early stage as a cancer in the mucosal layer. The ESD as minimally invasive surgery is useful and should be put to practical use everywhere.
