title: Local recurrence after rectal endoscopic submucosal dissection: a case of tumor cell implantation.
abstract: We report a case of local recurrence of cancer after rectal endoscopic submucosal dissection (ESD). A 52-year-old male underwent a curative resection with ESD for rectal intramucosal cancer. Seventy-four months after ESD, surveillance colonoscopy showed an elevated lesion on the ESD scar, suspicious of a recurrence. The patient subsequently underwent a low anterior resection (intersphincteric) with lymph node dissection. Pathology revealed a well-differentiated adenocarcinoma, similar to the ESD specimen. We suspected that the local recurrence was caused by implantation of tumor cells during the ESD, due to surgical manipulation performed with the tumor in an exposed setting for a long period of time.
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.
authors: Takashi
authors: T
authors: Inoue
authors: Department of Endoscopy and Ultrasound, Nara Medical University Hospital, Kashihara, Japan.
authors: Hisao
authors: H
authors: Fujii
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan ; Department of Endoscopy and Ultrasound, Nara Medical University Hospital, Kashihara, Japan.
authors: Fumikazu
authors: F
authors: Koyama
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.
authors: Tadashi
authors: T
authors: Nakagawa
authors: Department of Endoscopy and Ultrasound, Nara Medical University Hospital, Kashihara, Japan.
authors: Kazuaki
authors: K
authors: Uchimoto
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.
authors: Shinji
authors: S
authors: Nakamura
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.
authors: Takeshi
authors: T
authors: Ueda
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.
authors: Naoto
authors: N
authors: Nishigori
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.
authors: Keijiro
authors: K
authors: Kawasaki
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.
authors: Shinsaku
authors: S
authors: Obara
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.
authors: Takayuki
authors: T
authors: Nakamoto
authors: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara 634-8522 Japan.
authors: Yoshiyuki
authors: Y
authors: Nakajima
mesh_terms: D004210:Dissection / Q000379:methods; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D009366:Neoplasm Seeding; D011351:Proctoscopy; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: Colorectal endoscopic submucosal dissection; Intraluminal lavage; Local recurrence; Tumor cell implantation