Abstract
A 76-year-old female patient was diagnosed with depressed type colitic cancer using surveillance colonoscopy. She had been diagnosed with ulcerative colitis (UC) at 48 years of age, relapsing at 75 years. Following successful treatment of the relapse, she was monitored in our department. Colonoscopy identified a tumor─a reddish 1.5 cm depressed lesion with slightly-elevated margins─in the rectum. When magnified using narrow-band imaging (NBI), irregular capillary enhancement featured in the depressed area, and a VI pit pattern was detected using indigo carmine dye spraying. The tumor was resected laparoscopically, because the lesion was suspected to be in the deeper submucosal layer. After surgery, pathological analysis showed subserosal invasion beyond the preoperative diagnosis (Stage II)；therefore open surgery was utilised to enable D2 lymph node dissection.
In the case of this patient, the series of procedures─that would normally be used with standard colonic cancer instead of total colectomy─was selected after consideration of the patient’s postoperative quality of life, age and wishes. Postoperative recovery was good and the patient is now under close observation.
