Endoscopy 2018; 50(04): S17
DOI: 10.1055/s-0038-1637075
ESGE Days 2018 oral presentations
20.04.2018 – Colon: Improving detection
Georg Thieme Verlag KG Stuttgart · New York

THE ENDOSCOPIC AND CLINICOPAHOLOGIC CHARACTERISTICS OF DE NOVO COLON CANCERS

J Park
1   Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea, Republic of
,
JO Kim
1   Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea, Republic of
,
SR Jeon
1   Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea, Republic of
,
HG Kim
1   Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea, Republic of
,
TH Lee
1   Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea, Republic of
,
JS Lee
1   Digestive Disease Center, Soonchunhyang University Hospital, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Most colon cancers occurs via the adenoma-carcinoma sequence. Some colon cancers bypass this sequence and directly appears from normal tissues. We investigated the endoscopic and clinico-pathologic features of early colon cancers originating de novo.

Methods:

In an academic hospital, 292 pathologic specimens of early colon cancers taken by endoscopic removal or surgical resection from 252 patients were reviewed retrospectively. De novo colon cancer was defined as early colon cancers without adjacent adenoma.

Results:

Mean lesion size of 17 (4%) de novo cancers from 16 patients (mean age 60 ± 9 years, male n = 10) was 1.24 ± 0.55 cm. Most lesions were located in the left colon; rectum 6 (35.3%), sigmoid colon 5 (29.4%), descending colon 4 (23.5%), and transverse colon 2 (11.7%). Elevated type was common; Is/Isp 5/2 (41.2%), IIa (+IIc) 3/2 (29.4%), IIc (+IIa) 3/1 (23.5%), and laterally spreading tumor 1 (5.8%). Central erosions or ulcers were seen in 6 (35.3%). Submucosal and lymphvascular invasion showed in 10 (58.8%) and 4 (23.5%), respectively.

Conclusions:

Although de novo colon cancers comprise only 4% of early colon cancer, there was showed high rate of submucoal and lymphovascular invasion. Therefore, it should be managed cautiously because de Novo cancer may be very aggressive even though it has a very small size.