SMALL DEPRESSED CANCER OF THE LARGE-BOWEL - REPORT OF 3 CASES

This report describes three patients in whom colonescopy detected smal l depressed cancers (without an elevated component) that had invaded t he submucosa. They represent 0.4% (3/884) of all patients with invasiv e cancers and 3% (3/101) of patients with submucosal cancers in the Na tional Cancer Center Hospital between January 1990 and February 1994. This type of cancer may have been overlooked in the past because of it s small, flat nature. A slight deformity of the lumen, a faint color c hange (slightly reddish), and a loss of a vascular network pattern wer e important colonoscopic findings. Small depressed cancers may follow a different pathway to advanced cancer than polypoid cancers, although both pathways are included in the adenomacarcinoma sequence. We shoul d be aware of these lesions in our efforts to detect colorectal cancer s in the early stage.