Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2020; 12(9): 304-309
Published online Sep 16, 2020. doi: 10.4253/wjge.v12.i9.304
Small invasive colon cancer with adenoma observed by endocytoscopy: A case report
Yoshika Akimoto, Shin-ei Kudo, Katsuro Ichimasa, Yuta Kouyama, Masashi Misawa, Tomokazu Hisayuki, Toyoki Kudo, Tetsuo Nemoto
Yoshika Akimoto, Shin-ei Kudo, Katsuro Ichimasa, Yuta Kouyama, Masashi Misawa, Tomokazu Hisayuki, Toyoki Kudo, Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama 224-8503, Japan
Tetsuo Nemoto, Department of Pathology, Showa University Northern Yokohama Hospital, Yokohama 224-8503, Japan
Author contributions: Akimoto Y, Kudo S and Ichimasa K contributed to concept and design, literature review, drafting of the manuscript; Kouyama Y, Misawa M, Hisayuki T, Kudo T and Nemoto T acquired the data and figures and revised the manuscript; all authors had access and approved the last version of the manuscript.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: All authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE 2016 Checklist, and the manuscript was prepared and revised according to the CARE 2016 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Katsuro Ichimasa, MD, PhD, Assistant Professor, Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama 224-8503, Japan. ichitommy14@yahoo.co.jp
Received: May 27, 2020
Peer-review started: May 27, 2020
First decision: July 4, 2020
Revised: July 16, 2020
Accepted: August 24, 2020
Article in press: August 24, 2020
Published online: September 16, 2020
Abstract
BACKGROUND

Endocytoscopy is a next-generation endoscopic system that facilitates real-time histopathologic endoscopic diagnosis of colorectal lesions by virtue of its 520 × maximum magnification.

CASE SUMMARY

We present the case of a 63-year-old man with sigmoid colon cancer who was regularly referred for follow-up colonoscopy after endoscopic resection of T1 rectal cancer. Colonoscopy revealed a 12 mm reddish polyp, including a depression and a flat area in the sigmoid colon. Endocytoscopic observation showed unclear gland formation and agglomeration of distorted nuclei (depression), suggesting a submucosal invasive (T1) cancer. In the flat area, slit-like smooth lumens and regular pattern of fusiform nuclei were found, suggesting an adenoma. On the basis of these endocytoscopic findings, we predicted this lesion as T1 cancer (depression) with adenoma (flat area) and performed endoscopic resection corresponding to the final histopathological diagnosis.

CONCLUSION

We could perform an optical diagnosis of T1 sigmoid cancer with adenoma by using endocytoscopy before treatment.

Keywords: Endocytoscopy, T1 colorectal cancer, Adenoma, Optical diagnosis, Case report

Core Tip: Endocytoscopy is a next-generation endoscopic system. Endocytoscopic observation suggested that a 12 mm reddish polyp, including a depression and a flat area in the sigmoid colon was T1 cancer (depression) with adenoma (flat area). We could perform an optical diagnosis of the lesion by using endocytoscopy before treatment.