Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(09): E1130-E1133
DOI: 10.1055/a-0584-7060
Case report
Owner and Copyright © Georg Thieme Verlag KG 2018

Endoscopic submucosal dissection for early squamous cell carcinoma in the anal canal and Lugol chromoendoscopy for assessment of the lateral margin

Takeshi Uozumi
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Tetsuya Sumiyoshi
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Hitoshi Kondo
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Takeyoshi Minagawa
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Ryoji Fujii
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Masahiro Yosida
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Kaho Tokuchi
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Takuya Mizukami
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Koutarou Morita
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Hideyuki Ihara
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Yutaka Okagawa
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Toshizo Takayama
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Shutaro Ooiwa
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Michiaki Hirayama
1   Department of Gastroenterology, Tonan Hospital, Sapporo, Japan
,
Yumiko Oyamada
2   Department of Pathology, Tonan Hospital, Sapporo, Japan
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Publikationsverlauf

submitted 15. Dezember 2017

accepted after revision 23. Januar 2018

Publikationsdatum:
11. September 2018 (online)

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Abstract

A 66-year-old man underwent follow-up colonoscopy after colon polypectomy. The retroflexed view of the anal canal with white-light imaging revealed a whitish, slightly elevated lesion on the dentate line and an ill-defined flat lesion. A biopsy of the whitish elevation revealed squamous cell carcinoma (SCC), and endoscopic submucosal dissection (ESD) was planned. The lateral margin of the SCC was identified by spraying with Lugol’s iodine, and the tumor was resected en bloc with no complications. The pathological findings were SCC in situ with parakeratosis in the whitish elevation and high-grade intraepithelial neoplasia in the ill-defined flat lesion, which exhibited a wide iodine-unstained area by chromoendoscopy. Early SCC in the anal canal is a rare gastrointestinal cancer, and Lugol chromoendoscopy helped visualize the tumor margin for ESD.