A rapidly-growing colon polyp

A 54-year-old man underwent colonoscopy in our hospital which showed the presence of multiple polyps with a diameter in the range of 0.5–1.0 cm in the entire colon, one of which was located in the sigmoid colon with a diameter of 0.5 cm, with a IIa type pit pattern (Fig. 1A). Polypoid growth (PG)-type tumor was considered. The patient was admitted to our hospital 7 months later due to personal reasons. During the operation, a sigmoid lesion which had grown to about 1.0 cm and exhibited a IIa+Is type pit pattern was found (Fig. 1B). A diagnosis of non-polypoid growth (NPG)-type tumor was suspected. Subsequently, the surgical method was changed to endoscopic submucosal dissection. Intraoperatically, we observed that the lesion had a good lift sign and no significant adhesion was seen in the submucosa layer (Fig. 1C). After excision, the tumor specimen was examined by staining. Results identified type I and type II pit patterns were observed at the edges of the lesion, and a type Vn pit pattern were observed in the center (Fig. 1D,E). Postoperative pathology confirmed that the adenocarcinoma had invaded the deep submucosa (Fig. 2A, H&E staining, × 40, Fig. 2B, H&E staining, × 100). Postoperative immunohistochemistry confirmed the existence of cancer thrombi in the vasculature (Fig. 2C, CD34+, × 100). We have resected the slices again and did not find any obvious sprouting phenomenon (Fig. 2D, H&E staining, × 100). Fig. 2Postoperative pathology confirmed that adenocarcinoma invaded deep submucosa (A, H&E, × 40, B, H&E staining, × 100,). Postoperative immunohistochemistry suggested the presence of cancer thrombi in the vasculature (C, CD34+, × 100). We have resected the slices again and have not yet found any obvious sprouting phenomenon (D, H&E staining, × 100). View Large Image Figure Viewer Download Hi-res image