A Case of the Locally Recurrent Carcinoma 6.5 years after Colonoscopic Polypectomy

Abstract

The patient was a 53-year-old woman. She received colonoscopic polypectomy 6.5 years ago for sigmoid colon polyp. The resected specimen revealed well differentiated adenocarcinoma invading massively into the submucosal layer with vascular vessel invasion. She was recommended for an additional surgical resection but she refused. She was followed up by barium enema and colonoscopy and serum CEA.
No evidence of recurrence was detected until 6.5 years after the polypectomy, when she had bloody stool and barium enema revealed submucosal tumor-like protrusion with depression at the site of the previous lesion. Resection of the sigmoid colon was carried out successfully, and no lymph node metastasis was observed. The tumor was well differentiated adenocarcinoma invading to the serosal surface, mainly located in the submucosal layer, suggesting local recurrence of the tumor.
This is the case having the longest period of local recurrence after polypectomy, by the review of the Japanese literature. The authors suggest that long term follow up would be necessary after polypectomy of colonic carcinoma invading into submucosal layer.