Diagnosis of a submucosal mass at the staple line after sigmoid colon cancer resection by endoscopic cutting-mucosa biopsy.
A 48-year-old man underwent laparoscopic sigmoid colon resection for cancer and surveillance colonoscopy was performed annually thereafter. Five years after the resection, a submucosal mass was found at the anastomotic staple line, 15 cm from the anal verge. Computed tomography scan and endoscopic ultrasound were not consistent with tumor recurrence. Endoscopic mucosa biopsy was performed to obtain a definitive diagnosis. Mucosal incision over the lesion with the cutting needle knife technique revealed a creamy white material, which was completely removed. Histologic examination showed fibrotic tissue without caseous necrosis or tumor cells. No bacteria, including mycobacterium, were found on culture. The patient remains free of recurrence at five years since the resection. Endoscopic biopsy with a cutting mucosal incision is an important technique for evaluation of submucosal lesions after rectal resection.
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Mitsuaki
M
Morimoto
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Koji
K
Koinuma
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Alan K
AK
Lefor
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Hisanaga
H
Horie
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Homare
H
Ito
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Naohiro
N
Sata
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Yoshikazu
Y
Hayashi
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Keijiro
K
Sunada
Mitsuaki Morimoto, Koji Koinuma, Alan K Lefor, Hisanaga Horie, Homare Ito, Naohiro Sata, Department of Surgery, Jichi Medical University, Tochigi 329-0498, Japan.
Hironori
H
Yamamoto
Endoscopic cutting-mucosa biopsy; Staple line; Submucosal tumor