[A Case Report of Suspicious of Lymph Node Metastasis after Endoscopic Mucosal Resection for Sigmoid Colon Carcinoma In Situ].

A 71-year-old man underwent endoscopic mucosal resection(EMR)of a sigmoid colon polyp 7 years ago. The pathological result was adenocarcinoma(pap+tub2+tub1), pTis, ly(-), v(-). Then he was under observation. This time, a 20 mm submucosal tumor-like finding was found near the scar after EMR, and a biopsy revealed a diagnosis of adenocarcinoma (tub2). CT scan showed lymphadenopathy beside sigmoid colon. There were no non-resectable factors, so a laparoscopic sigmoid resection was performed. The pathological result showed adenocarcinoma(tub2), and although some parts were continuous with the mucosa, the majority of the tumor was located from submucosa to subserosa, and it was diagnosed as direct invasion into the lymph nodes outside the wall, and the possibility of lymph node recurrence was suspected. He underwent adjuvant chemotherapy CAPOX. In order to establish the optimal surveillance of colon carcinoma in situ, it is important to accumulate further cases and evidence.