A case of colonic carcinoma type IIc＋Is with sm massive invasion

Abstract

A 55-year-old male complaining occult blood in stool underwent colonoscopy, colonic carcinoma was detected in the sigmoid colon.
Endoscopic examination revealed an elevated lesion with a depression on the anal side. On magnifying endoscopic observation, type V_N pit pattern was observed in the depressed area. A massively submucosal invasive carcinoma was highly suspected, and sigmoid colectomy was performed.
The resected specimen showed a IIc＋Is lesion, measurihg 12×10mm in diameter includings showed well differentiated adenocarcinoma in the elevated area, and moderately differentiated adenocarcinoma in the depressed area, The depth of invasion was m in the elevated area, and sm² in the depressed area. Neoplastic cells positive for p53 and Ki-67 were observed in depressed area, but these cells were sparsely seen in elevated area.
We surmise that depression may be arised from a part of elevated lesion because these lesions had remarkable differences in their forms and biological characters.