RSS-Feed abonnieren
DOI: 10.1055/s-2002-33564
© Georg Thieme Verlag Stuttgart · New York
Superficial Depressed-Type Cancer Monitored by Colonoscopy through the Early Phase of Invasion
Publikationsverlauf
Submitted: 16 March 2002
Accepted after Revision: 16 April 2002
Publikationsdatum:
26. August 2002 (online)
![](https://www.thieme-connect.de/media/endoscopy/200209/lookinside/thumbnails/10.1055-s-2002-33564-1.jpg)
Although previous retrospective reports have demonstrated the developmental course of several colorectal tumors, the natural history and progression of depressed carcinoma, especially in the early stage, remains obscure. We report a case of superficial depressed tumor in the transverse colon in a 71-year-old man, which did not change in size and gross configuration through prospective colonoscopic observation over a period of 19 months but which was finally diagnosed as early-stage submucosal invasive cancer. Most depressed cancers have been supposed to arise de novo and grow rapidly, showing aggressive behavior when 10 mm or less in size. However, this case report may suggest that even a depressed tumor may grow to approximately 10 mm within the mucosal layer over a few years and that the growth of colorectal tumors, whether they are polypoid or depressed in configuration, might be fairly slow.
References
- 1 Kudo S, Tamura S, Nakajima T. et al . Depressed type of colorectal cancer. Endoscopy. 1995; 27 54-57
- 2 Rembacken B J, Fujii T, Cairns A. et al . Flat and depressed colonic neoplasms: a prospective study of 1000 colonoscopies in the UK. Lancet. 2000; 355 1211-1214
- 3 Stolte M, Bethke B. Colorectal mini-de novo carcinoma: a reality in Germany too. Endoscopy. 1995; 27 286-290
- 4 Ishii H, Tatsuta M, Tsutsui S. et al . Early depressed adenocarcinomas of the large intestine. Cancer. 1992; 69 2406-2410
- 5 Minamoto T, Sawaguchi K, Ohta T. et al . Superficial-type adenomas and adenocarcinomas of the colon and rectum: a comparative morphological study. Gastroenterology. 1994; 106 1436-1443
- 6 Hayakawa M, Shimokawa K, Kusugami K. et al . Clinicopathological features of superficial depressed-type colorectal neoplastic lesions. Am J Gastroenterol. 1999; 94 944-949
- 7 Matsui T, Yao T, Yao K. et al . Natural history of superficial depressed colorectal cancer: retrospective radiographic and histologic analysis. Radiology. 1996; 201 226-232
- 8 Matsui T, Yao T, Iwashita A. Natural history of early colorectal cancer. World J Surg. 2000; 24 1022-1028
- 9 Hisabe T, Tsuda S, Matsui T. et al . Invasive colon cancer derived from a small superficial depressed cancer: report of a case. Dis Colon Rectum. 2000; 43 S98-S103
- 10 Umetani N, Muto T, Kawamura Y J. et al . Superficial depressed early carcinoma that developed into protuberant advanced carcinoma in the transverse colon. J Gastroenterol. 2001; 36 48-51
- 11 Kudo S, Kashida H, Tamura T. et al . Colonoscopic diagnosis and management of nonpolypoid early colorectal cancer. World J Surg. 2000; 24 1081-1090
- 12 Morson B C. Evolution of cancer of the colon and rectum. Cancer. 1974; 34 845-849
- 13 Muto T, Bussey H JR, Morson B C. The evolution of cancer of the colon and rectum. Cancer. 1975; 36 2251-2270
- 14 Spratt J S, Ackerman L V, Moyer C A. Relationship of polyps of the colon to colonic cancer. Ann Surg. 1958; 148 682-698
- 15 Castleman B, Krickstein H I. Do adenomatous polyps of the colon become malignant?. N Engl J Med. 1962; 267 469-475
- 16 Stryker S J, Wolff B G, Culp C E. et al . Natural history of untreated colonic polyps. Gastroenterology. 1987; 93 1009-1013
- 17 Knoernschild H E. Growth rate and malignant potential of colonic polyps: early results. Surg Forum. 1953; 14 137-138
- 18 Hoff G, Foerster A, Vatn M H. et al . Epidemiology of polyps in the rectum and colon. Scand J Gastroenterol. 1986; 21 853-862
- 19 Bersentes K, Fennerty M B, Sampliner R E. et al . Lack of spontaneous regression of tubular adenomas in two years of follow-up. Am J Gastroenterol. 1997; 92 1117-1120
- 20 Kuramoto S, Oohara T. Flat early cancers of the large intestine. Cancer. 1989; 64 950-955
- 21 Kuramoto S, lhara O, Sakai S. et al . Depressed adenoma in the large intestine: endoscopic features. Dis Colon Rectum. 1990; 33 108-112
- 22 Yao T, Tsuneyoshi M. Significance of pericryptal fibroblasts in colorectal epithelial tumors: a special reference to the histologic features and growth patterns. Hum Pathol. 1993; 24 525-533
- 23 Yao T, Tsuneyoshi M, Matsumoto T. et al . Depressed adenoma of the colorectum: analysis of proliferative activity using immunohistochemical staining for proliferating cell nuclear antigen (PCNA). Pathol Int. 1994; 44 520-527
- 24 Kobayashi M, Watanabe H, Ajioka Y. et al . Proliferating cell nuclear antigen/cyclin expression in small adenomas of the large intestine in relation to size and macroscopic appearance. J Gastroenterol. 1994; 29 139-146
- 25 Suzuki Y, Honma T, Hayashi S. et al . Bcl-2 expression and frequency of apoptosis correlate with morphogenesis of colorectal neoplasia. J Clin Pathol. 2002; 55 212-217
Y. Suzuki, M.D.
Division of Gastroenterology and Hepatology · Department of Cellular Function · Niigata University Graduate School of Medical and Dental Sciences
1-757 Asahimachi-dori · Niigata 951-8510 · Japan
Fax: + 81-25-2270776
eMail: sanmac@med.niigata-u.ac.jp