A Case of Colonic Muco-submucosal Elongated Polyp (CMSEP) Presented with Hematochezia.

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  • HIRANO Akira
    Department of Surgery, Daini Hospital, Tokyo Women's Medical University Department of Surgery, Shin-Yahashiradai Hospital
  • OKABE Toshihiro
    Department of Surgery, Daini Hospital, Tokyo Women's Medical University Department of Surgery, Shin-Yahashiradai Hospital
  • ENDO Shungo
    Department of Surgery, Daini Hospital, Tokyo Women's Medical University
  • YOKOMIZO Hajime
    Department of Surgery, Daini Hospital, Tokyo Women's Medical University Department of Surgery, Shin-Yahashiradai Hospital
  • YOSHIMATSU Kazuhiko
    Department of Surgery, Daini Hospital, Tokyo Women's Medical University Department of Surgery, Shin-Yahashiradai Hospital
  • KATO Hiroyuki
    Department of Surgery, Daini Hospital, Tokyo Women's Medical University
  • HAGA Shunsuke
    Department of Surgery, Daini Hospital, Tokyo Women's Medical University
  • KAJIWARA Tetsuro
    Department of Surgery, Daini Hospital, Tokyo Women's Medical University

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Other Title
  • 血便を契機に発見されたｃｏｌｏｎｉｃ　ｍｕｃｏ‐ｓｕｂｍｕｃｏｓａｌ　ｅｌｏｎｇａｔｅｄ　ｐｏｌｙｐ（ＣＭＳＥＰ）の１例

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Abstract

A 70-year-old man was admitted to the hospital for close examination of hematochezia. Endoscopic colonoscopy revealed a pediculate polyp with the longer diameter of 4cm in the descending colon. Since endoscopic resection was considered to be difficult, a portion of the descending colon was resected surgically. The polyp consisted of mucosa and submucosal tissue. A part of its surface transformed by ulceration and hyperplastic changes, however, most parts were covered with normal mucosa. Only fibrogenesis and angiogenesis were observed in the submucosal layer. On the basis of the above findings, the polyp was considered to meet the criteria for colonic muco-submucosal elongated polyp (CMSEP). In the present case, not only the mucosa and submucosal tissue but also a part of the muscularis were elongated toward the pedicle of the polyp. It is suggested that meticulous care must be exercised in performing endoscopic treatment for CMSEP.

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