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Primary adenocarcinoma arising from rectal implantation cyst after low anterior resection for rectal cancer 31 years previously.

Authors :
Shimada Y
Matsumoto A
Abe K
Tajima Y
Nakano M
Ariizumi T
Kawashima H
Tani Y
Ohashi R
Wakai T
Source :
Clinical journal of gastroenterology [Clin J Gastroenterol] 2024 Oct; Vol. 17 (5), pp. 899-903. Date of Electronic Publication: 2024 Jun 10.
Publication Year :
2024

Abstract

Rectal implantation cysts can occur at anastomotic sites after low anterior resection (LAR) for rectal cancer. Herein, we report a case of primary adenocarcinoma arising from a rectal implantation cyst after LAR for rectal cancer. A 70-year-old woman was referred to our hospital for diagnosis and treatment of a growing cystic lesion. She had LAR performed for rectal cancer 29 years previously and had a rectal implantation cyst detected 13 years previously. On the first visit to our hospital, serum CEA and CA19-9 levels were elevated, and computed tomography (CT) scans revealed a cystic lesion near the anastomosis. CT-guided biopsy revealed no cancer tissue in the cystic lesion. After that, the cystic lesion naturally shrank, and serum CEA and CA19-9 levels became normal. Follow-up included 3 monthly serum CEA and CA19-9 testing and 6 monthly CT scans. Two years later, serum CEA and CA19-9 levels were elevated again. Colonoscopy revealed an ulcerative lesion at the anastomotic site, in which adenocarcinoma was confirmed. Abdominoperineal resection with sacral resection was performed, and postoperative histopathological examination revealed a primary adenocarcinoma with mucinous component at the implantation cyst. Since rectal implantation cysts can become malignant after extended periods, clinicians need to be aware of this disease.<br /> (© 2024. Japanese Society of Gastroenterology.)

Details

Language :
English
ISSN :
1865-7265
Volume :
17
Issue :
5
Database :
MEDLINE
Journal :
Clinical journal of gastroenterology
Publication Type :
Academic Journal
Accession number :
38853185
Full Text :
https://doi.org/10.1007/s12328-024-02002-0