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Endoscopic submucosal dissection of a squamous cell carcinoma in situ in the anal canal diagnosed by magnifying endoscopy with narrow-band imaging

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Abstract

A 60-year-old female underwent screening colonoscopy. Narrow-band imaging (NBI) without magnification showed a 20-mm, well-demarcated brownish area located close to the dentate line of the anal canal. Conventional white-light imaging revealed an ill-defined, flat lesion with scattered reddish spots at the same site. Magnifying endoscopy with NBI (M-NBI) revealed abnormal microvessels with dilatation, tortuosity, caliber change and various shapes that were similar to the intrapapillary capillary loop patterns seen in esophageal squamous cell carcinoma in situ. Endoscopic submucosal dissection (ESD) was performed, and on histological examination, the resected specimen showed squamous cell carcinoma (SCC) in situ and clear surgical margins. Thus, NBI is an efficient method for detecting superficial SCC in the anal canal and M-NBI may be useful for determining the extent of the lesion. During screening colonoscopy, the anal region should be carefully observed using NBI, as early detection offers a greater opportunity for ESD which is a less invasive procedure.

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Disclosures

Conflict of Interest:

Shigetsugu Tsuji, Hisashi Doyama, Shinya Yamada, Kei Tominaga, Ryosuke Ota, Akane Yoshikawa, Masanori Kotake, Hideki Ohno and Hiroshi Kurumaya declare that they have no conflict of interest.

Human/Animal Rights:

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

Informed Consent:

Informed consent was obtained from a patient for being included in the study.

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Authors and Affiliations

  1. Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan

    Shigetsugu Tsuji, Hisashi Doyama, Shinya Yamada, Kei Tominaga, Ryosuke Ota & Akane Yoshikawa

  2. Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan

    Masanori Kotake

  3. Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan

    Hiroshi Kurumaya

  4. OHNO Internal Medicine Clinic, Kanazawa, Japan

    Hideki Ohno

Authors
  1. Shigetsugu Tsuji
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  2. Hisashi Doyama
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  3. Shinya Yamada
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  4. Kei Tominaga
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  5. Ryosuke Ota
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  6. Akane Yoshikawa
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  7. Masanori Kotake
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  8. Hideki Ohno
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  9. Hiroshi Kurumaya
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Correspondence to Shigetsugu Tsuji.

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Tsuji, S., Doyama, H., Yamada, S. et al. Endoscopic submucosal dissection of a squamous cell carcinoma in situ in the anal canal diagnosed by magnifying endoscopy with narrow-band imaging. Clin J Gastroenterol 7, 233–237 (2014). https://doi.org/10.1007/s12328-014-0481-7

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  • DOI: https://doi.org/10.1007/s12328-014-0481-7

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