Endoscopic submucosal tunnel dissection for a giant adenoma of the cecum (case report)

Abstract

Endoscopic removal of giant adenomas of the cecum is associated with high risk of perforation and conversion to laparoscopic procedure. Endoscopic submucosal dissection for cecal adenomas had technical limitations due to the adjacent ileocecal valve and appendix opening, perpendicular operating angle. Case presentation of the possibility of successful removal of a large laterally spreading cecal adenoma by the method of endoscopic submucosal tunnel dissection (ESTD) never been described before for this tumor site and size. Patient 54 years old, an LST-G adenoma (5 cm in diameter, according to Kudo – IIIL, according to Sano – II) was detected in the dome of the cecum during colonoscopy. ESTD. The postoperative period without any unfavorable events; the patient was discharged on the 5th day after surgery. The morphological conclusion: tubulo-villous adenoma with moderate epithelial dysplasia, R0. ESTD is suitable for cecal giant adenomas.