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Small Depressed Cancer of the Large Bowel: Report of Three Cases
Authors:Toshihiro Yokota  MD    Kenichi Sugihara  MD    Tadashi Yokoyama  MD    Hitoshi Kondo  MD    Masashi Oka  MD    Kuniaki Shirao  MD    Daizo Saito  MD    Hajime Yamaguchi  MD    Yanao Oguro  MD    Tsutomu Ishikawa  MD    Atsushi Ochiai  MD    Shigeaki Yoshida  MD
Institution:Departments of Endoscopy. Surgery, Diagnostic Radiology, and Pathology. National Cancer Center Hospital, Tokyo, Japan;and Department of Endoscopy. National Cancer Center Hospital East, Chiba. Japan
Abstract:This report describes three patients in whom colonos-copy detected small depressed cancers (without an elevated component) that had invaded the submucosa. They represent 0.4% (3/884) of all patients with invasive cancers and 3% (3/101) of patients with submucosal cancers in the National Cancer Center Hospital between January 1990 and February 1994. This type of cancer may have been overlooked in the past because of its small, flat nature. A slight deformity of the lumen, a faint color change (slightly reddish), and a loss of a vascular network pattern were important colonoscopic findings. Small depressed cancers may follow a different pathway to advanced cancer than polypoid cancers, although both pathways are included in the adenoma-carcinoma sequence. We should be aware of these lesions in our efforts to detect colorectal cancers in the early stage.
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