title: Dome-type carcinoma of the colon; a rare variant of adenocarcinoma resembling a submucosal tumor: a case report.
abstract: BACKGROUND
  Dome-type carcinoma (DC) is a distinct variant of colorectal adenocarcinoma and less than 10 cases have been described in the literature. Most of the previously reported cases were early lesions and no endoscopic observations have been described so far. We herein report a case of a DC invading the subserosal layer, including endoscopic findings.
  
  
  METHODS
  A highly elevated lesion in the transverse colon was diagnosed by colonoscopy in a 77-year-old man. The tumor appeared to be similar to a submucosal tumor (SMT), however, a demarcated area of reddish and irregular mucosa was observed at the top of the tumor. There were no erosions or ulcers. Laparoscopic-assisted right hemicolectomy was performed and pathological examination revealed a well-circumscribed tumor invading the subserosal layer. The tumor was a well-differentiated adenocarcinoma associated with a dense lymphocytic infiltration and showed expansive growth. The overlying mucosal layer showed high-grade dysplasia.
  
  
  CONCLUSIONS
  The present lesion was diagnosed as a DC of the colon invading the subserosal layer. Because the association of mucosal dysplasia is common in DCs, the detection of dysplastic epithelium would be important to discriminate DCs from SMTs.
authors.affiliation: Pathology Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yamada
authors.forename: Shigeki
authors.initials: S
authors.lastname: Sekine
authors.forename: Takahisa
authors.initials: T
authors.lastname: Matsuda
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kushima
authors.forename: Taku
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
authors.forename: Takayuki
authors.initials: T
authors.lastname: Akasu
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D000368:Aged; D003082:Colectomy; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D003113:Colonoscopy; D003937:Diagnosis, Differential; D006801:Humans; D010535:Laparoscopy; D008297:Male; D016896:Treatment Outcome