title: Invasive rectal cancer treated with a combination of endoscopic submucosal dissection and chemoradiation.
abstract: A 68-year-old man underwent total colonoscopy because of a positive fecal occult blood test. A polypoid lesion (Is + IIa), 20 mm in size, was detected in the very lower part of the rectum. A large reddish nodule suggesting invasive carcinoma was seen on conventional view. Magnifying chromoendoscopy, however, disclosed a non-invasive pit pattern in that part. Moreover, magnifying narrow band imaging showed a type IIIA capillary pattern. Therefore, endoscopic submucosal dissection was successfully conducted for en bloc resection. Histologically, it was a rectal submucosal invasive carcinoma deeply invading into the submucosal layer with vascular invasion. Although additional surgical treatment was suggested, the patient refused the proposal and received chemoradiation therapy to avoid a permanent colostomy. Periodic evaluation revealed no local or distant metastasis 3 years thereafter.
authors.affiliation: Department of Gastroenterology, Juntendo University Nerima Hospital, Tokyo, Japan. fukuangi@hotmail.com
authors.forename: Kuang I
authors.initials: KI
authors.lastname: Fu
authors.forename: Hironori
authors.initials: H
authors.lastname: Konuma
authors.forename: Hiroya
authors.initials: H
authors.lastname: Ueyama
authors.forename: Taiji
authors.initials: T
authors.lastname: Saga
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000628:therapy*; D059248:Chemoradiotherapy; D003113:Colonoscopy; D003937:Diagnosis, Differential; D004210:Dissection / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology* / Q000601:surgery; D008297:Male; D009361:Neoplasm Invasiveness; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000628:therapy*; D014057:Tomography, X-Ray Computed