Endoscopic Curative Treatment of a Submucosal Invasive Rectal AdenocarcinomaCarlos Eduardo Oliveira dos Santos1*, Daniele Malaman1, César Vivian Lopes2 and Júlio Carlos Pereira-Lima2
- *Corresponding Author:
- Carlos Eduardo Oliveira dos Santos
Rua Gomes Carneiro, 1343, CEP 96400-130, Bagé-RS, Brazil
E-mail: [email protected]
Received date: May 23, 2014; Accepted date: June 18, 2014; Published date: June 24, 2014
Citation: Oliveira dos Santos CE, Malaman D, Lopes CV, Pereira-Lima JC (2014) Endoscopic Curative Treatment of a Submucosal Invasive Rectal Adenocarcinoma. J Gastroint Dig Syst 4:193. doi:10.4172/2161-069X.1000193
Copyright: © 2014 Oliveira dos Santos CE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
We report a case of a 45-year-old man with the diagnosis of rectal adenocarcinoma, in which a proctocolectomy was proposed and the patient refrained from surgery. A new colonoscopy was performed, which revealed a 2.5 cm diameter sessile lesion with irregular microvascular mesh work, thick capillaries with heterogeneous distribution and avascular areas, suggesting carcinoma with massive invasion of the sub-mucosa (a C3 lesion in the Hiroshima classification). However, we tried endoscopic resection and the lesion has completely elevated after Sub-mucosal hipertonic saline injection. Then the lesion was removed “en block” with a polypectomy snare. Histopathological study evidenced a moderately differentiated adenocarcinoma in a villous adenoma with high grade dysplasia with sub-mucosal invasion of 655 μm; there was no angiolymphatic invasion and the lateral and lower margins were lesion-free.