title: Repeatedly recurrent colon cancer involving the appendiceal orifice after endoscopic piecemeal mucosal resection: a case report.
abstract: Local recurrence after endoscopic piecemeal mucosal resection (EPMR) for colorectal tumors is a crucial issue. However, such recurrence is usually detected within one year and cured with additional endoscopic treatment, which makes EPMR acceptable. Herein, we report a rare case of repeatedly recurrent colon cancer involving the appendiceal orifice after EPMR, which was not cured with additional endoscopic treatments. A 67-year-old man was referred to us for endoscopic treatment of a 25 mm cecal tumor spreading to the appendiceal orifice in May 2002. The tumor was resected with EPMR, showing well differentiated intramucosal adenocarcinoma with a positive lateral cut margin of tubular adenoma. Endoscopic surveillance was conducted and the first local recurrence was detected in August 2006. Although we resected it endoscopically, the second local recurrence was found in September 2007 and we removed it with endoscopic resection again. However, the third local recurrence was detected in March 2008. Although endoscopic resection was performed also for the third recurrence, curative resection was not achieved. In February 2009, laparoscopic assisted colectomy was performed and histopathological examination showed well differentiated adenocarcinoma with deep submucosal invasion. This case is important in considering indication for endoscopic resection in colorectal tumors involving the appendiceal orifice.
authors.affiliation: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Masau
authors.initials: M
authors.lastname: Sekiguchi
authors.forename: Takahisa
authors.initials: T
authors.lastname: Matsuda
authors.forename: Shigeki
authors.initials: S
authors.lastname: Sekine
authors.forename: Taku
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kushima
authors.forename: Takayuki
authors.initials: T
authors.lastname: Akasu
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D001063:Appendiceal Neoplasms / Q000150:complications; D003082:Colectomy; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local; D012008:Recurrence