Yamamoto Takafumi, Hamajima Eiji, Kamioka Tsuguo, Nakae Yasuyuki, Nakashima Sayori, Kuno Takeshi, Ito Makoto, Fujishiro Mitsuhiro
Department of Gastroenterology, Kariya Toyota General Hospital.
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine.
Nihon Shokakibyo Gakkai Zasshi. 2021;118(8):757-767. doi: 10.11405/nisshoshi.118.757.
This study included a 45-year-old woman. In 20XX, we performed colonoscopy (CS) on fresh bloody stools, and a diagnosis of rectal mucosal prolapse syndrome (MPS) was made. In 20XX+14 years, CS was reexamined because of fresh bloody stools, and a biopsy of the same site revealed well-differentiated tubular adenocarcinoma. The lesion was resected via endoscopic submucosal dissection (ESD) and histopathologically diagnosed as MPS with high-grade adenoma and well-differentiated tubular adenocarcinoma. The symptoms improved after ESD, and no recurrence was observed during the 18-month follow-up. We experienced a case of a well-differentiated tubular adenocarcinoma in MPS during the long-term follow-up of MPS. In this case, performing ESD was useful not only for cancer treatment but also in terms of therapeutic effects on symptoms. Although MPS is a chronic benign inflammatory disorder, characterized by rectal mucosal prolapse with fibromuscular obliteration, it is necessary to consider the possibility of the appearance of cancer during the follow-up of MPS.
本研究纳入了一名45岁女性。20XX年，因新鲜便血行结肠镜检查（CS），诊断为直肠黏膜脱垂综合征（MPS）。20XX + 14年，因新鲜便血再次行CS检查，同一部位活检显示为高分化管状腺癌。病变经内镜黏膜下剥离术（ESD）切除，组织病理学诊断为MPS伴高级别腺瘤和高分化管状腺癌。ESD术后症状改善，18个月随访期间未观察到复发。我们在MPS的长期随访中遇到了一例MPS合并高分化管状腺癌的病例。在该病例中，实施ESD不仅对癌症治疗有用，而且在症状治疗效果方面也有帮助。虽然MPS是一种慢性良性炎症性疾病，其特征为直肠黏膜脱垂伴纤维肌肉闭塞，但在MPS随访期间有必要考虑癌症出现的可能性。
