Primary micropapillary carcinoma of the colon with submucosal invasion: A case report

Youichi Miyaoka; Aya Fujiwara; Satoshi Kotani; Kosuke Tsukano; Sayaka Ogawa; Satoshi Yamanouchi; Ryusaku Kusunoki; Hirofumi Fujishiro; Naruaki Kohge; Tomohiko Yamamoto; Yuji Amano

doi:10.1055/s-0042-106721

Endoscopy International Open, Table of Contents

Endosc Int Open 2016; 04(07): E744-E747
DOI: 10.1055/s-0042-106721

Case report

Primary micropapillary carcinoma of the colon with submucosal invasion: A case report

Youichi Miyaoka

¹Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan

,

Aya Fujiwara

²Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan

,

Satoshi Kotani

²Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan

,

Kosuke Tsukano

²Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan

,

Sayaka Ogawa

²Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan

,

Satoshi Yamanouchi

²Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan

,

Ryusaku Kusunoki

²Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan

,

Hirofumi Fujishiro

¹Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan

,

Naruaki Kohge

²Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan

,

Tomohiko Yamamoto

³Division of Pathology, Shimane Prefectural Central Hospital, Shimane, Japan

,

Yuji Amano

⁴Division of Endoscopy, Kaken Hospital, International University of Health and Welfare, Chiba, Japan

› Author Affiliations

Abstract

Background and study aims: We present a case of invasive micropapillary carcinoma (IMPC) of the colon treated by endoscopic resection following magnifying endoscopy. A 47-year-old woman visited our hospital for follow-up of a positive fecal occult blood test. Colonoscopy revealed a semi-pedunculated reddish polyp, the surface of which showed gentle irregularity, and mild tension in the sigmoid colon. Magnifying colonoscopy with narrow band imaging revealed an irregular surface pattern with heterogeneity in vascular diameter and distribution. Magnifying endoscopic findings using crystal violet staining showed an irregular pit pattern with an expansion of stromal areas. Endoscopic resection of the sigmoid colon tumor was performed, and the histology of the resected specimen primarily revealed a micropapillary component with a small moderately differentiated adenocarcinoma component that massively invaded into the submucosal layer, accompanied by lymphatic invasion, although the tumor was very small (7 mm in diameter, smaller than any in previous reports). Laparoscopy-assisted sigmoidectomy and regional lymph node resection were performed; neither cancer nor lymph node metastases were present. This is the first report of a case with early-stage colonic IMPC observed with magnifying colonoscopy.

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References

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