title: Sigmoidectomy for radiation-induced sigmoid colonic dysplasia 35 years after radiotherapy for cervical cancer.
abstract: Although radiation-induced colonic cancer is thought to arise from dysplasia, no guidelines exist for the treatment of such dysplasia. Therefore, clinicians must make treatment decisions for this condition on a case-by-case basis. Especially when the operative procedure is being decided, it is necessary to consider postoperative quality of life for advanced age. We report a patient who underwent sigmoidectomy for sigmoid colonic dysplasia that developed 35 years after radiation therapy. A 73-year-old woman who had undergone total hysterectomy and chemoradiotherapy for cervical cancer 35 years previously presented following a positive fecal occult blood test. Colonoscopy revealed sigmoid colonic dysplasia. To ensure reliable removal of the lesion, we elected to perform surgical resection. Given the patient's age, we performed sigmoidectomy rather than resecting the entire irradiated intestinal tract. The diagnosis of dysplasia was confirmed based on pathological findings, which included duct proliferation with partial structural atypia.
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan. k-uchi@naramed-u.ac.jp.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Uchimoto
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Koyama
authors.affiliation: Department of Ultrasound and Endoscopy, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Fujii
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakagawa
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ohtsuki
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ueda
authors.affiliation: Department of Diagnostic Pathology, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Enomoto
authors.affiliation: Department of Diagnostic Pathology, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Akitaka
authors.initials: A
authors.lastname: Nonomura
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara, 634-8522, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
keywords: Radiation-induced dysplasia; Surgical procedure; Therapeutic strategy