Asploro Journal of Biomedical and Clinical Case Reports
Article Type: Case Report
Asp Biomed Clin Case Rep. 2020 Jul 07;3(2):151-59
Matsuda K1*, Hashiguchi Y1, Asako K1, Ohno K1, Okada Y1, Tsukamoto M1, Fukushima Y1, Shimada R1, Ozawa T1, Hayama T1, Nozawa K1, Fukagawa T1, Sasajima Y2
1Departments of Surgery, Teikyo University School of Medicine, Tokyo, Japan
2Departments of Pathology, Teikyo University School of Medicine, Tokyo, Japan
Corresponding Author: Keiji Matsuda ORCID ID
Address: Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Received date: 11 June 2020; Accepted date: 26 June 2020; Published date: 07 July 2020
Citation: Matsuda K, Hashiguchi Y, Asako K, Ohno K, Okada Y, Tsukamoto M, Fukushima Y, Shimada R, Ozawa T, Hayama T, Nozawa K, Fukagawa T, Sasajima Y. Disseminated Colitic Cancer Identified in Two Patients who had Undergone Surveillance Colonoscopies: A Case Report. Asp Biomed Clin Case Rep. 2020 Jul 07;3(2):151-59.
Copyright © 2020 Matsuda K, Hashiguchi Y, Asako K, Ohno K, Okada Y, Tsukamoto M, Fukushima Y, Shimada R, Ozawa T, Hayama T, Nozawa K, Fukagawa T, Sasajima Y. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: Ulcerative Colitis, Colitic Cancer, Advanced Cancer, Surveillance Colonoscopy
Abbreviations: SC: Surveillance Colonoscopy, UC: Ulcerative Colitis, OS: Overall Survival
Background: It was reported that in surveillance colonoscopy (SC), targeted and random biopsies detected similar proportions of neoplasias. However, that study was conducted by experienced endoscopists familiar with colitic cancer. We report two cases of disseminated colitic cancer in patients who had undergone SC.
Case Presentation: Case-1: A 69-year-old Japanese man first suffered from ulcerative colitis (UC) in 1979. Annual SCs had been performed since 1998. In 2017, colonoscopy confirmed a cancer in the ascending colon. A laparoscopy-assisted anal-preserving total proctocolectomy was performed in 2018. Histological findings showed the cancer reaching serosa and lymph node metastasis. Peritoneal dissemination occurred 1 year after the surgery. Two years after the first surgery, an ileostomy was created due to bowel obstruction caused by peritoneal dissemination.
Case-2: A 77-year-old Japanese man was diagnosed with UC at another hospital in 2010. SCs were performed annually since 2011. In April 2019, he developed frequent bowel movements, bleeding, and weight loss. Colonoscopy revealed stenosis at the rectum and sigmoid colon. The biopsy revealed adenocarcinoma. Laparoscopy-assisted surgery was performed in July 2019. The yellow ascites was aspirated and submitted for lavage cytology, which revealed signet-ring cell carcinoma. Many white nodules were found in the peritoneum and were diagnosed as peritoneal dissemination. A colostomy was performed. Chemotherapy was administered. Five months have passed since the operation, and the patient is alive.
Conclusion: Chromoendoscopy had not been performed in either patient. It is advisable to use chromoendoscopy when a target biopsy is performed.