Abstract

CUMANA, R et al. Disección mucosal endoscópica de cáncer gástrico en paciente con poliposis colonica. Gen [online]. 2011, vol.65, n.3, pp.240-242. ISSN 0016-3503.

Endoscopic mucosal dissection (DME), arises from endoscopic mucosal resection (EMR), allowing resection malignant lesions in early stage, achieving cure rates of up to 99%, decreasing morbidity and mortality of traditional surgery. It is important to obtain the piece completely, as this way, the pathologist may report the margins of the lesion extent and depth. Case report: This male patient aged 40 years, valued for our service (August 2009) by clinical evolution of 4 months, changes in the pattern of voiding (bowel diarrhea) and bleeding rectal. Consulting specialist, performed colonoscopy finding means is rectal tumor, with positive biopsy for adenocarcinoma, so refer to our center. Personal and family history: no contributory. Gastroscopy was performed which reported: Injury anterior antrum, high background ulcerated, depressed, amputation of folds, it is concluded: IIc early gastric Ca. Endoscopic Ultrasound: Thickening of the mucosa and muscle of the antral mucosa. Posterior. Biopsy: No atypia. Colonoscopy: tu. lower rectum. Colonic polyposis. Transrectal endoscopic ultrasound: Tu. UT2N1 lower rectum. Biopsy: moderately differentiated adenocarcinoma. Given the characteristics of gastric injury is endoscopic submucosal dissection dedide perform, with biopsy reports: early intramucosal carcinoma, resection margins free of injury. patient receives Neoadjuvant cancer treatment and subsequently coloproctoanastomosis. Current developments satisfactory. Discussion: The endoscopic appearance of lesions plays an important role in the conduct to be followed by the doctor and is key to consider when conducting DME because it is a procedure that carries risks and has specific indications for and results obertener raised. It has proven to be safe and effective in the treatment of early cancer, but not only esophageal stomach and colon, increasing patient survival. Colonic polyposis patients without family history often have symptoms at younger age and prone to colonic carcinoma is higher. The average age of onset of polyps ranged from 26 to 28 years and the interval between the onset of adenomas and symptoms is 10 years. Importantly, these patients may have extraintestinal manifestations, and cancer in other locations in the digestive tract, 10% of these are related to the occurrence of gastric cancer. It is important to the investigation by endoscopy in these patients.

Keywords : Early; Dissection; Polyps.