Genetically proven multiple tumor cell seeding on the wounds of endoscopic resection from an intramucosal rectal cancer

Abstract

An 82-year-old man with a history of Hartmann’s procedure was referred for the treatment of tumors in the remnant rectum (A). We conducted endoscopic snare resection surrounding the small lesions before treating the main large lesion (B, C). The pathologic diagnosis was tubular adenoma. One month after the initial treatment, we conducted endoscopic submucosal dissection (ESD) for the main large lesion. The pathologic diagnosis was moderately differentiated intramucosal tubular adenocarcinoma. At the time of ESD, we found small lesions at the post–snare resection wounds (D) and these lesions had enlarged in 6 months after ESD (E).