Disseminated Colitic Cancer Identified in Two Patients who had Undergone Surveillance Colonoscopies: A Case Report

Matsuda K^1*, 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; Tel: +81-3-3964-1211; Fax: +81-3-5375-6097; Email: keiji@med.teikyo-u.ac.jp

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

Abstract

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.

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