Images in Clinical Medicine

Laterally Spreading Colon Cancer

Satoru Tamura, M.D., Ph.D., and Saburo Onishi, M.D., Ph.D.

N Engl J Med 2004; 351:e24December 23, 2004

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Article

A 74-year-old man was referred for evaluation after a positive fecal occult-blood test. He had no history of cancer and no family history of colorectal cancer. A colonoscopy was performed with the use of a magnifying videoscope, and an irregularity of the colonic wall at the transverse colon was detected (Panel A). The laterally spreading tumor became clear after a 0.2 percent indigo carmine solution was sprayed in the area (Panel B, arrows). A radiograph obtained after the administration of a double-contrast barium enema showed a flat, radiolucent area (Panel C, arrows). The patient underwent a laparoscopically assisted colectomy, and a tumor 5 cm in diameter was removed. Histologic examination showed invasion of the cancer in the submucosa, without invasion of the vessels or involvement of the lymph nodes (Panel D, hematoxylin and eosin). Follow-up after discharge was uneventful. After eight months, there has been no evidence of metastasis.

Satoru Tamura, M.D., Ph.D.
Saburo Onishi, M.D., Ph.D.
Kochi Medical School, Nankoku, Kochi 783-8505, Japan

Citing Articles (4)

Citing Articles

1. 1

   Eisuke Kaku, Yasushi Oda, Yoshitaka Murakami, Hideyo Goto, Tomofumi Tanaka, Kiwamu Hasuda, Makoto Yasunaga, Kiyoharu Ito, Kouichi Sakurai, Takahiro Fujimori, Masahiro Hattori, Yutaka Sasaki. (2011) Proportion of Flat- and Depressed-Type and Laterally Spreading Tumor Among Advanced Colorectal Neoplasia. Clinical Gastroenterology and Hepatology 9:6, 503-508
   CrossRef

2. 2

   Yoshinori Kuratani, Satoru Tamura, Yasuo Furuya, Saburo Onishi. (2008) Morphogenesis of a colorectal neoplasm with a type IIIS pit pattern inferred from isolated crypts. Journal of Gastroenterology 43:8, 597-602
   CrossRef

3. 3

   Kazuo Nakajo, Satoru Tamura, Makoto Hiroi, Saburo Onishi, Nobufumi Yasuda. (2007) EVALUATION OF THE RISK FACTORS OF LYMPH NODE METASTASIS IN PT1 STAGE COLORECTAL CARCINOMA: INDICATION FOR AN ENDOSCOPIC MUCOSAL RESECTION. Digestive Endoscopy 19:4, 174-179
   CrossRef

4. 4

   Shinichi Hashimoto, Shingo Higaki, Ayaka Amano, Katsunori Harada, Jun Nishikawa, Tomoharu Yoshida, Kiwamu Okita, Isao Sakaida. (2007) Relationship between molecular markers and endoscopic findings in laterally spreading tumors. Journal of Gastroenterology and Hepatology 22:1, 30-36
   CrossRef