Intestinal Research

Original Article

Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas: Ji Yeon Seo, Seung Ho Choi, Jaeyoung Chun, Changhyun Lee, Ji Min Choi, Eun Hyo Jin, Sung Wook Hwang, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim; Intest Res 2016;14(3):270-279. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.270

<b>Background/Aims</b><br/>

The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps.

Methods

Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed.

Results

Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period.

Conclusions

Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy.

Citations

Citations to this article as recorded by

Small sessile serrated polyps might not be at a higher risk for future advanced neoplasia than low-risk adenomas or polyp-free groups
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Scandinavian Journal of Gastroenterology.2022; 57(1): 99. CrossRef
The incidence and risk factors of sessile serrated adenomas in left side colon cancer patients after curative surgery
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Improved Real-Time Optical Diagnosis of Colorectal Polyps Following a Comprehensive Training Program
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Clinical Gastroenterology and Hepatology.2019; 17(12): 2479. CrossRef
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Journal of Gastroenterology and Hepatology.2018; 33(5): 1039. CrossRef
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Medicine.2017; 96(27): e7468. CrossRef

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Case Reports

A Case of Immune Thrombocytopenic Purpura Associated with Preexisting Ulcerative Colitis Treated with Colectomy and Splenectomy: Jee Hye Kwon, Changhyun Lee, Ji Min Choi, Yoo Min Han, Young Hoon Choi, June Young Lee, Hyuk Yoon, Jaeyoung Chun, Kyu Joo Park, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung; Intest Res 2013;11(4):310-316. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.310

Abstract PDF

Ulcerative colitis is a chronic inflammatory bowel disease of unknown etiology, associated with extraintestinal manifestations, including the rarely reported immune thrombocytopenic purpura. Here, we present a case of immune thrombocytopenic purpura associated with preexisting ulcerative colitis. The patient was diagnosed with ulcerative colitis 13 years ago. Two years after diagnosis, he presented with hematochezia and active ulcerative colitis. Despite steroid use, the platelet count gradually decreased to 21,000/mm3. Hematochezia and the platelet count recovered after the administration of cyclosporine, and ulcerative colitis was in near complete remission for 11 years. However, the patient was re-admitted for hematochezia and thrombocytopenia persisting over a month. Medical management including increased doses of steroids in combination with cyclosporin failed to control hematochezia and thrombocytopenia. Immune thrombocytopenic purpura was suspected on the basis of normocellular marrow with a normal number of megakaryocytes. To treat uncontrolled colitis and steroid-refractory thrombocytopenia, total proctocolectomy with ileal pouch-anal anastomosis and splenectomy were performed. The patient was followed up for 10 months after surgery and was found to be in good health with a normal platelet count. Therefore, colectomy alone or in combination with splenectomy should be considered in cases of life-threatening ulcerative colitis complicated with steroid-refractory immune thrombocytopenic purpura. (Intest Res 2013;11:310-316)

Citations

Citations to this article as recorded by

Resolved Hypereosinophilic Syndrome and Immune Thrombocytopenic Purpura in Ulcerative Colitis Patients Post Colectomy: A Case Series and Literature Review
Ahmed Hussein Subki, Manal Ismail Bokhary, Sultan Abdulrahman Alandijani, Mohannad Abdulrahman Aljehani, Ahmed Wasel Alharbi, May Alzahrani, Saud Suliman Almuhammadi, Bassim Tahseen Albeirouti, Mohamed Abdulmajid Abduljabar, Silvio Danese
Journal of Inflammation Research.2022; Volume 15: 6373. CrossRef
A Case of Immune Thrombocytopenic Purpura Accompanying Ulcerative Colitis
Hyun Tae Kim, Tae Oh Kim, Hyung Jun Kim, Soon Il Lee, Gi Jung Jeon, Eun Ji Lee, Seunghyun Park, Taehoon No
The Korean Journal of Gastroenterology.2014; 64(4): 234. CrossRef

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Clinical Characteristics of Lower Gastrointestinal Cancer in Crohn's Disease: Case Series of 5 Patients: Ji Min Choi, Changhyun Lee, Yoo Min Han, Minjong Lee, Dong Kee Jang, Jeehye Kwon, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung; Intest Res 2013;11(2):127-133. Published online April 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.2.127

Abstract PDF

Crohn's disease is a chronic inflammatory disease that can involve the entire gastrointestinal tract. Several studies indicate that Crohn's patients with long disease duration have an increased risk of small bowel or colorectal cancer. In Korea, only a few cases of Crohn's disease-related small bowel or colorectal cancer have been reported. Here, we described 3 cases of colorectal cancer and 2 cases of small bowel cancer in patients with Crohn's disease. Among 5 patients, 3 had Crohn's disease-related lower gastrointestinal malignancy and the other 2 had sporadic lower gastrointestinal malignancies. Since the diagnosis of Crohn's disease-related lower gastrointestinal malignancy tends to be delayed, the development of malignancy should be considered in patients with long duration of Crohn's disease if patients have refractory symptoms despite intensive medical treatment. Surgical consultation should not be delayed. (Intest Res 2013;11:127-133)

Citations

Citations to this article as recorded by

Metastatic Recurrence of Small Bowel Cancer in Crohn's Disease
Ji Min Choi, Changhyun Lee, Jong Pil Im
The Korean Journal of Gastroenterology.2014; 63(4): 258. CrossRef

3,006 View
17 Download
1 Crossref

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