CASE OF A MINUTE SESSILE LESION OF THE SIGMOID COLON WITH MASSIVE CANCER INVOLVEMENT IN THE SUBMUCOSAL LAYER.

A 53-year-old man was referred to our hospital because of the appearance of a positive fecal occult immunological reaction. We found a domed lesion 0.4 cm in diameter in the sigmoid colon. Bleeding spots were observed on the surface of the lesion on endoscopy. We performed endoscopic mucosal resection of the lesion, which was found to contain well-differentiated adeno-carcinoma and cancer cells infiltrating to the cut-end of resected specimen. Laparoscopy-assisted sigmoidectomy was then performed with dissection of the lymph nodes. The dissected lesion was diagnosed as adenocarcinoma with moderate fibrosis and massive cancerous involvement. The patient died of recurrent cancer 3 years after the operation. In the minute sessile lesion, bleeding spots on the surface may suggest invasive cancer with massive cancer involvement within the submucosal layer. [ABSTRACT FROM AUTHOR]