alexa Endoscopic Curative Treatment of a Submucosal Invasive Rectal Adenocarcinoma
ISSN: 2161-069X

Journal of Gastrointestinal & Digestive System
Open Access

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Case Report

Endoscopic Curative Treatment of a Submucosal Invasive Rectal Adenocarcinoma

Carlos Eduardo Oliveira dos Santos1*, Daniele Malaman1, César Vivian Lopes2 and Júlio Carlos Pereira-Lima2

1Department of Gastroenterology and Endoscopy, Santa Casa de Caridade Hospital, Bagé, RS, Brazil

2Department of Gastroenterology and Endoscopy, Santa Casa Hospital, Porto Alegre, RS, Brazil

*Corresponding Author:
Carlos Eduardo Oliveira dos Santos
Rua Gomes Carneiro, 1343, CEP 96400-130, Bagé-RS, Brazil
Tel: +55-53-3241-6955
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

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