Yonsei Med J.  2007 Dec;48(6):1075-1078. 10.3349/ymj.2007.48.6.1075.

A Case of More Abundant and Dysplastic Adenomas in the Interposed Colon than in the Native Colon

• Hwang HJ
• Song KH
• Youn YH
• Kwon JE
• Kim H
• Chung JB
• Lee YC

• KMID: 1786230
• DOI: http://doi.org/10.3349/ymj.2007.48.6.1075

Abstract

We report a 60-year-old woman with intramucosal adenocarcinoma arising in the interposed colon, 40 years after the esophageal reconstruction for lye induced esophageal stricture. Although synchronous adenomas were also found in the native colon where the graft was taken, the number of adenomas was greater in the interposed colon and more dysplastic, even progressed to adenocarcinoma, than that of the native colon. The microsatellite instability-testing performed in the intramucosal carcinoma from interposed colon showed absence of microsatellite instability. Changing of location and functional deman]d of colonic segment, and the exposure to different intraluminal contents might have facilitated the adenoma- carcinoma transformation in the interposed colon.

Keyword

Esophageal colon interposition; adenocarcinoma

MeSH Terms

Adenocarcinoma/pathology
Adenoma/etiology/*pathology
Colon/*pathology
Colonic Neoplasms/etiology/*pathology
Disease Progression
Esophagoplasty/adverse effects/methods
Female
Humans
Middle Aged
Postoperative Complications/etiology/pathology
Time Factors

Figure

• 

  Fig. 1 (A, B, C, D) Arrows indicate the flat elevated mucosal lesion in the interposed colon, located at the anastomosis site and measuring 12 mm (A). Another flat elevated lesion located 4 cm proximal to the anastomosis site, measuring 20 mm is indicated with arrow heads (B). These polyps were removed by snare polypectomy after the submucosal injection of saline (C, D).

• 

  Fig. 2 (A, B) Pathology of the resected 20 mm sized adenoma showing tubulo-villous adenoma with high grade dysplasia and focus of intramucosal well-differentiated adenocarcinoma. (A × 100 and B × 400).

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  Fig. 3 The result of the MSI-testing using five microsatellite markers, BAT25, BAT 26, D2S123, D5S346 and D17S250, showed no shift of bands relative to control bands (upper: control, lower: specimen of patient).

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