抄録
We diagnosed and treated 4 extremely rare cases of early stage of poorly differentiated large bowel adenocarcinoma.
All cases were evaluated as 0-IIa＋IIc, and the whole lesion showed submucosal tumor-like protrusion. In magnifying endoscopy with crystal violet staining, the depressed area were observed as VN pit patterns. All were preoperatively diagnosed as submucosal invasive carcinomas. As an initial approach, lymph node dissection was performed in 3 cases. We performed endoscopic mucosal resection for a total excisional biopsy in 1 case, but needed additional surgery. Histologically, all submucosal invasive carcinomas were mainly composed of poorly differentiated adenocarcinoma. They were positive for vascular invasion. Although all were the early stage of poorly differentiated large bowel adenocarcinoma, 1 case was positive for lymph node metastasis. Surgical resection with lymph node dissection was required for treatment.
It is difficult to make conclusive remarks on the endoscopic findings, therefore more detailed analysis using a large number of cases required.
