A case of rapidly progressing and poorly differentiated Ip‐type early‐stage colorectal adenocarcinoma

Abstract A 36‐year‐old woman visited our hospital with a chief complaint of bleeding during defecation. Colonoscopy revealed a 20‐mm pedunculated polyp in the sigmoid colon, which was en bloc resected under endoscopy. The histopathological diagnosis was adenoma cancer with a depth of invasion indica...

Full description

Saved in:
Bibliographic Details
Main Authors: Atsuko Tsubomoto, Hiroshi Sashiyama, Junichi Koike, Yohei Morita, Osamu Tsutsumi, Yukihiro Hamahata
Format: Article
Language:English
Published: Wiley 2023-04-01
Series:DEN Open
Subjects:
Online Access:https://doi.org/10.1002/deo2.181
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849726944472465408
author Atsuko Tsubomoto
Hiroshi Sashiyama
Junichi Koike
Yohei Morita
Osamu Tsutsumi
Yukihiro Hamahata
author_facet Atsuko Tsubomoto
Hiroshi Sashiyama
Junichi Koike
Yohei Morita
Osamu Tsutsumi
Yukihiro Hamahata
author_sort Atsuko Tsubomoto
collection DOAJ
description Abstract A 36‐year‐old woman visited our hospital with a chief complaint of bleeding during defecation. Colonoscopy revealed a 20‐mm pedunculated polyp in the sigmoid colon, which was en bloc resected under endoscopy. The histopathological diagnosis was adenoma cancer with a depth of invasion indicating mucosal cancer, no lymphovascular invasion, and negative at the resection margin. The poorly differentiated adenocarcinoma component comprised approximately 5% of the tumor. Although there were no recurrence signs in the computed tomography scans obtained 4 months post polypectomy, the patient experienced aggressive lower back pain at 6 months post polypectomy. Local recurrence, peritoneal dissemination, and liver metastasis were confirmed. Finally, the patient died following a rapid and aggressive deterioration of her general condition. Histological examination of the local recurrence revealed a poorly differentiated adenocarcinoma (por2), with immunostaining revealing a high Ki67 positivity rate of 95%. Moreover, the poorly differentiated adenocarcinoma region of the resected polyp had a Ki67 positivity rate of 90%, which suggested that they were the same tumors. These findings suggested that the recurrence could have occurred through implantation.
format Article
id doaj-art-41549db28ea24c1392cf86fabbdee5ff
institution DOAJ
issn 2692-4609
language English
publishDate 2023-04-01
publisher Wiley
record_format Article
series DEN Open
spelling doaj-art-41549db28ea24c1392cf86fabbdee5ff2025-08-20T03:10:01ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.181A case of rapidly progressing and poorly differentiated Ip‐type early‐stage colorectal adenocarcinomaAtsuko Tsubomoto0Hiroshi Sashiyama1Junichi Koike2Yohei Morita3Osamu Tsutsumi4Yukihiro Hamahata5Department of Colorectal Surgery Tsujinaka Hospital Kashiwanoha Chiba JapanDepartment of Colorectal Surgery Tsujinaka Hospital Kashiwanoha Chiba JapanDepartment of Colorectal Surgery Tsujinaka Hospital Kashiwanoha Chiba JapanDepartment of Colorectal Surgery Tsujinaka Hospital Kashiwanoha Chiba JapanDepartment of Colorectal Surgery Tsujinaka Hospital Kashiwanoha Chiba JapanDepartment of Colorectal Surgery Tsujinaka Hospital Kashiwanoha Chiba JapanAbstract A 36‐year‐old woman visited our hospital with a chief complaint of bleeding during defecation. Colonoscopy revealed a 20‐mm pedunculated polyp in the sigmoid colon, which was en bloc resected under endoscopy. The histopathological diagnosis was adenoma cancer with a depth of invasion indicating mucosal cancer, no lymphovascular invasion, and negative at the resection margin. The poorly differentiated adenocarcinoma component comprised approximately 5% of the tumor. Although there were no recurrence signs in the computed tomography scans obtained 4 months post polypectomy, the patient experienced aggressive lower back pain at 6 months post polypectomy. Local recurrence, peritoneal dissemination, and liver metastasis were confirmed. Finally, the patient died following a rapid and aggressive deterioration of her general condition. Histological examination of the local recurrence revealed a poorly differentiated adenocarcinoma (por2), with immunostaining revealing a high Ki67 positivity rate of 95%. Moreover, the poorly differentiated adenocarcinoma region of the resected polyp had a Ki67 positivity rate of 90%, which suggested that they were the same tumors. These findings suggested that the recurrence could have occurred through implantation.https://doi.org/10.1002/deo2.181early‐stage cancerimplantationIp‐typeKi67 antigenpoorly differentiated colorectal adenocarcinoma
spellingShingle Atsuko Tsubomoto
Hiroshi Sashiyama
Junichi Koike
Yohei Morita
Osamu Tsutsumi
Yukihiro Hamahata
A case of rapidly progressing and poorly differentiated Ip‐type early‐stage colorectal adenocarcinoma
DEN Open
early‐stage cancer
implantation
Ip‐type
Ki67 antigen
poorly differentiated colorectal adenocarcinoma
title A case of rapidly progressing and poorly differentiated Ip‐type early‐stage colorectal adenocarcinoma
title_full A case of rapidly progressing and poorly differentiated Ip‐type early‐stage colorectal adenocarcinoma
title_fullStr A case of rapidly progressing and poorly differentiated Ip‐type early‐stage colorectal adenocarcinoma
title_full_unstemmed A case of rapidly progressing and poorly differentiated Ip‐type early‐stage colorectal adenocarcinoma
title_short A case of rapidly progressing and poorly differentiated Ip‐type early‐stage colorectal adenocarcinoma
title_sort case of rapidly progressing and poorly differentiated ip type early stage colorectal adenocarcinoma
topic early‐stage cancer
implantation
Ip‐type
Ki67 antigen
poorly differentiated colorectal adenocarcinoma
url https://doi.org/10.1002/deo2.181
work_keys_str_mv AT atsukotsubomoto acaseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT hiroshisashiyama acaseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT junichikoike acaseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT yoheimorita acaseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT osamutsutsumi acaseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT yukihirohamahata acaseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT atsukotsubomoto caseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT hiroshisashiyama caseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT junichikoike caseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT yoheimorita caseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT osamutsutsumi caseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma
AT yukihirohamahata caseofrapidlyprogressingandpoorlydifferentiatediptypeearlystagecolorectaladenocarcinoma