Depressed ‐type Submucosal Invasive Colorectal Cancer in a Patient with Lynch Syndrome Diagnosed Using Short Interval Colonoscopy

We report a case of colorectal cancer (CRC) detected by short interval surveillance colonoscopy (SC) in a patient with LS having a past history of partial colectomy. A 65‐year‐old man underwent sigmoidectomy for advanced CRC. His family history revealed that his two younger brothers had CRC in their twenties and thirties, respectively, and the patient met with the criteria in the Revised Bethesda Guidelines. After confirming the loss of MSH2 protein expression in the primary tumor, subsequent genetic testing showed germ line mutation with a large deletion of exon 7‐14 in the MSH2 gene, indicating a diagnosis of LS. After the diagnosis of LS, the patient underwent annual SC. Three years after the initial surgery, superficial submucosal invasive cancer was detected. Subsequently, SC after 6 months interval revealed a deep submucosal invasive cancer (7 mm in diameter). Although additional surgery was recommended, considering his comorbidities, regular SC rather than colectomy has been selected. Even shorter interval SC performed within a year is not enough to detect endoscopically resectable tumors in some high‐risk LS cases.

Source: Digestive Endoscopy - June 30, 2016 Category: Gastroenterology Authors: Kazuya Inoki, Takeshi Nakajima, Shigeki Sekine, Koukichi Sugano, Shunsuke Tsukamoto, Masayoshi Yamada, Michihiro Mutoh, Taku Sakamoto, Takahisa Matsuda, Masau Sekiguchi, Mineko Ushiama, Teruhiko Yoshida, Hiromi Sakamoto, Yukihide Kanemitsu, Yutaka Saito Tags: Case Report Source Type: research