Korean J Gastroenterol.  2012 Mar;59(3):257-259. 10.4166/kjg.2012.59.3.257.

A Case of Nonpolypoid Cancer Arising from Colonic Muco-submucosal Elongated Polyp

• Shin Y
• Kim JB
• Choi JS
• Lee KM
• Shin SR
• Park SH
• Kim JW
• Lee MS

• KMID: 1245212
• DOI: http://doi.org/10.4166/kjg.2012.59.3.257

Abstract

A colonic muco-submucosal elongated polyp (CMSEP) was identified at colonoscopy in a 53-year-old male patient with lower gastrointestinal bleeding. Non-polypoid depressed type of early cancer was noted at the tip of the colonic polyp. The CMSEP is very rare and incidentally found in most cases. Moreover, its association with colonic neoplasia is extremely rare. To our knowledge, this is the second case report of CMSEP associated with a cancerous transformation.

Keyword

Colonic polyps; Gastrointestinal hemorrhage; Colonic neoplasms

MeSH Terms

Colonic Neoplasms/*diagnosis/pathology
Colonic Polyps/*pathology
Colonoscopy
Gastrointestinal Hemorrhage
Humans
Intestinal Mucosa/*pathology
Male
Middle Aged

Figure

• 

  Fig. 1 Endoscopic findings. (A) An elongated polyp is seen on the proximal ascending colon. (B) Conspicuous erythema is noted on the tip of the elongated polyp. Snare polypectomy was performed just above hemoclipping site.

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  Fig. 2 Histologic findings. (A) A long thick polyp covered with mucosa containing muscularis mucosae is shown. In the thick stalk, many dilated blood vessels are found (H&E, original magnification). In the tip, tumor tissue with central depression is covered with noncancerous mucosa in the marginal area (arrows), indicating non-polypoid depressed type of early cancer. (B) Adenocarcinoma with downward growth pattern invades submucosa (H&E, ×40). A small foci of adenoma remnants is suspected in the adjacent noncancerous mucosa (arrows). Hemosiderin deposition is noted (arrow heads).

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