Kim San-Ha, Chae Gi-Bong, Lee Seung-Koo, Nam Seung-Joo
Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, Gangwon 24289, Republic of Korea.
Department of Surgery, Kangwon National University School of Medicine, Chuncheon, Gangwon 24289, Republic of Korea.
Mol Clin Oncol. 2025 Aug 7;23(4):91. doi: 10.3892/mco.2025.2886. eCollection 2025 Oct.
Colorectal cancer typically progresses from intramucosal carcinoma to invasive cancer, with lymph node metastasis considered possible only after submucosal invasion. Tumors confined to the mucosa are classified as carcinoma (Tis), based on the American Joint Committee on Cancer, and are generally not thought to be capable of metastasis. The present study reports a rare case of lymph node metastasis in a 70-year-old female with Tis rectal cancer, who presented to Kangwon National University School of Medicine in December 2018. Although the tumor was confined to the mucosa without evidence of lymphovascular invasion, histopathological examination demonstrated metastasis to a regional lymph node. The patient underwent laparoscopic resection followed by concurrent chemoradiotherapy, and she has remained recurrence-free for the past 6 years. This case challenges the conventional understanding of Tis-stage colorectal cancer and highlights the need for the re-evaluation of lymph node involvement in early-stage cases. Further research is necessary to explore the mechanisms underlying lymph node metastasis in Tis rectal cancer.
结直肠癌通常从黏膜内癌发展为浸润性癌，只有在黏膜下浸润后才被认为有可能发生淋巴结转移。根据美国癌症联合委员会的标准，局限于黏膜的肿瘤被分类为癌（Tis），一般认为其不具备转移能力。本研究报告了一例罕见的70岁女性Tis期直肠癌发生淋巴结转移的病例，该患者于2018年12月就诊于江原国立大学医学院。尽管肿瘤局限于黏膜，无淋巴管侵犯证据，但组织病理学检查显示区域淋巴结转移。该患者接受了腹腔镜切除术，随后进行同步放化疗，在过去6年中一直无复发。该病例挑战了对Tis期结直肠癌的传统认识，并强调了重新评估早期病例淋巴结受累情况的必要性。有必要进一步研究以探索Tis期直肠癌淋巴结转移的潜在机制。
