Local recurrence after successful endoscopic submucosal dissection for rectal mucinous mucosal adenocarcinoma:A case report  

作　　者：Yuki Murakami Hiroki Tanabe Yusuke Ono Yuya Sugiyama Yu Kobayashi Takehito Kunogi Takahiro Sasaki Keitaro Takahashi Katsuyoshi Ando Nobuhiro Ueno Shin Kashima Sayaka Yuzawa Kentaro Moriichi Yusuke Mizukami Mikihiro Fujiya Toshikatsu Okumura 

机构地区：[1]Division of Metabolism and Biosystemic Science,Department of Gastroenterology and Hematology/Oncology,Department of Medicine,Asahikawa Medical University,Asahikawa 078-8510,Hokkaido,Japan [2]Institute of Biomedical Research,Sapporo-Higashi Tokushukai Hospita,Sapporo 065-0033,Hokkaido,Japan [3]Department of Diagnostic Pathology,Asahikawa Medical University,Asahikawa 078-8510,Hokkaido,Japan

出　　处：《World Journal of Gastrointestinal Oncology》2023年第1期186-194,共9页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：BACKGROUND Mucinous adenocarcinoma of the colorectum is a rare histological subtype characterized by an abundant mucinous component.Mucinous tumors are frequently diagnosed at an advanced stage,which indicates an aggressive subtype.However,few case reports have been published,and little information is available concerning genetic alterations in mucinous adenocarcinoma.CASE SUMMARY A 76-year-old man underwent en bloc endoscopic submucosal dissection(ESD)for the management of a type 0-Is+IIa lesion.Histological examination revealed an intramucosal mucinous adenocarcinoma with signet-ring cell carcinoma and well-to-moderately differentiated tubular adenocarcinoma.Three years after the ESD,local recurrence was detected by an endoscopic examination,revealing a new 0-Is+IIa lesion with a phenotype similar to the previously resected lesion.Re-ESD was chosen for the management of the recurrent tumor,and the histological examination showed positive tumor infiltration at the vertical margin.Additional surgical resection was performed for the curative treatment.Genetic analysis showed pathogenic alterations in RNF43 and TP53 in the adenoma and an additional SMAD4 alteration in the carcinoma.CONCLUSION This mucinous mucosal adenocarcinoma case was suggested to have an aggressive phenotype and a careful and close follow-up are required.

关 键 词：Rectal cancer Mucinous adenocarcinoma Endoscopic submucosal dissectio TP53 Colitic cancer pathway Case report 

分 类 号：R735[医药卫生—肿瘤]