title: Depressed-type submucosal invasive colorectal cancer in a patient with Lynch syndrome diagnosed using short-interval colonoscopy.
abstract: Although regular colonoscopy surveillance is recommended for patients with Lynch syndrome (LS) who underwent partial colectomy, the appropriate interval has not been determined. We report a case of colorectal cancer (CRC) detected by short-interval surveillance colonoscopy (SC) in a patient with LS having a past history of partial colectomy. A 65-year-old man underwent sigmoidectomy for advanced CRC. His family history revealed that his two younger brothers had CRC in their twenties and thirties, respectively, and the patient met with the criteria in the Revised Bethesda Guidelines. After confirming the loss of MSH2 protein expression in the primary tumor, subsequent genetic testing showed germline mutation with a large deletion of exon 7-14 in the MSH2 gene, indicating a diagnosis of LS. After the diagnosis of LS, the patient underwent annual SC. Three years after the initial surgery, superficial submucosal invasive cancer was detected. Subsequently, SC after a 6-month interval revealed a deep submucosal invasive cancer (7 mm in diameter). Although additional surgery was recommended, considering his comorbidities, regular SC rather than colectomy was selected. Even shorter-interval SC carried out within a year is not sufficient to detect endoscopically resectable tumors in some high-risk LS cases.
authors: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Kazuya
authors: K
authors: Inoki
authors: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. tnakajim@ncc.go.jp.|Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan. tnakajim@ncc.go.jp.
authors: Takeshi
authors: T
authors: Nakajima
authors: Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan.|Molecular Pathology Division, National Cancer Center Research Institute, Tokyo, Japan.
authors: Shigeki
authors: S
authors: Sekine
authors: Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan.|Oncogene Research Unit/Cancer Prevention Unit, Tochigi Cancer Center Research Institute, Tochigi, Japan.
authors: Kokichi
authors: K
authors: Sugano
authors: Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Shunsuke
authors: S
authors: Tsukamoto
authors: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.|Cancer Screening Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors: Masayoshi
authors: M
authors: Yamada
authors: Division of Cancer Prevention Research, National Cancer Center Research Institute, Tokyo, Japan.
authors: Michihiro
authors: M
authors: Mutoh
authors: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Taku
authors: T
authors: Sakamoto
authors: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.|Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan.|Cancer Screening Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors: Takahisa
authors: T
authors: Matsuda
authors: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.|Cancer Screening Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors: Masau
authors: M
authors: Sekiguchi
authors: Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan.|Group for Cancer Development and Progression, Division of Genetics, National Cancer Center Research Institute, Tokyo, Japan.
authors: Mineko
authors: M
authors: Ushiama
authors: Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan.|Group for Cancer Development and Progression, Division of Genetics, National Cancer Center Research Institute, Tokyo, Japan.
authors: Teruhiko
authors: T
authors: Yoshida
authors: Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan.|Group for Cancer Development and Progression, Division of Genetics, National Cancer Center Research Institute, Tokyo, Japan.
authors: Hiromi
authors: H
authors: Sakamoto
authors: Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Yukihide
authors: Y
authors: Kanemitsu
authors: Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Yutaka
authors: Y
authors: Saito
mesh_terms: D000368:Aged; D003082:Colectomy; D003110:Colonic Neoplasms; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis*; D006801:Humans; D008297:Male
keywords: Lynch syndrome; adenoma detection rate; colorectal cancer; endoscopic resection; surveillance colonoscopy