[A Case of Local Recurrence, Lymph Node Metastasis, Multiple Pulmonary Metastases and Multiple Hepatic Metastases following EMR for T1a Rectal Cancer].

The patient was a man in his 40s who sought medical attention due to a positive fecal occult blood test. Colonoscopy revealed a 15 mm 0-Is lesion in the rectum Rb. Endoscopic mucosal resection(EMR)was performed. Pathological diagnosis showed a 0-Is, 15×15 mm, adenocarcinoma(tub1>tub2)in an adenoma, staged as pT1a(SM, 500 μm), INF b, Ly0, V0, BD1, pHM0(1 mm), pVM0(1 mm), ER0, pCurEA. During follow-up, he experienced fatigue 11 months post-EMR. Contrast-enhanced chest and abdominal CT scans, along with a colonoscopy, revealed local recurrence, lymph node metastasis, multiple pulmonary metastases, and multiple hepatic metastases following early-stage rectal cancer EMR. Despite systemic drug therapy, hepatic arterial infusion therapy, and palliative radiotherapy, the patient passed away 1 year and 9 months after EMR(10 months after recurrence). Regular surveillance is considered necessary following endoscopic resection of early colorectal cancer, although further case accumulation is needed to determine the intervals.