Tumor Budding and Recurrence in Submucosal Invasive Colorectal Cancers of Favorable Histology: Case Reports of Two Early Colorectal Cancers with Advanced Recurrences
박혜성, 장희진, 박지원, 김병창, 손대경, 홍창원, 백지연, 김선영, 최효성, 오재환,
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박혜성 ( Park Heae-Surng )
Seoul National University College of Medicine Department of Pathology
장희진 ( Chang Hee-Jin )
National Cancer Center Center for Colorectal Cancer
박지원 ( Park Ji-Won )
National Cancer Center Center for Colorectal Cancer
김병창 ( Kim Byung-Chang )
National Cancer Center Center for Colorectal Cancer
손대경 ( Sohn Dae-Kyung )
National Cancer Center Center for Colorectal Cancer
홍창원 ( Hong Chang-Won )
National Cancer Center Center for Colorectal Cancer
백지연 ( Baek Ji-Yeon )
National Cancer Center Center for Colorectal Cancer
김선영 ( Kim Sun-Young )
National Cancer Center Center for Colorectal Cancer
최효성 ( Choi Hyo-Seong )
National Cancer Center Center for Colorectal Cancer
오재환 ( Oh Jae-Hwan )
National Cancer Center Center for Colorectal Cancer
KMID : 0357920120460030272
Abstract
Complete resection of submucosal invasive colorectal cancer (SICC) showing favorable histology is regarded as curative. We report on two cases of SICC showing recurrence within 5 years despite complete resection. The first patient was a 68-year-old woman with well differentiated rectal adenocarcinoma invading the superficial submucosa, which recurred after 4.7 years. The second patient was a 53-year-old man with pT1N0 moderately differentiated colonic adenocarcinoma. He developed widespread tumor recurrence after 3.9 years. Retrospective pathologic review of the original tumors showed multiple foci of tumor budding at the invasive front. Immunohistochemical staining for D2-40 of deeper levels of the paraffin blocks showed rare foci of small lymphatic invasion. Tumor budding at the invasive front may be an important indicator for SICC aggressiveness or may reflect early lymphatic invasion. More aggressive pathologic examination and follow-up is required for patients with SICC showing tumor budding, even in the absence of unfavorable histologic findings.
키워드
Early colorectal neoplasms; Tumor budding; Recurrence
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