Brief:
CA in situ in the setting of Acute Ulcerative Proctitis

Description:

• 72/M patient has come to us with c/o increased stool frequency and bleeding per rectum for last few months with some wt loss. Recent CT Scan showed a possibility of mass in the rectum with nodes
• Ileo-Colonoscopic findings are suggestive of active ulcerative colitis affecting the recto sigmoid up to around 5 cms from the anal verge with large sessile lesion
• Rectal EUS was then performed with a radial echo endoscope, which revealed essentially mucosal lesion limited to the muscularis mucosa
• EMR (endoscopic mucosal resection) was then carried out with saline adrenaline injection followed by resection with snare and cautery. Complete resection was ensured and haemostasis was secured
• Resected specimen was retrieved and sent for HPE which was diagnosed as adenocarcinoma

Image:

1.Large sessile lesion was seen in the rectum

2.Rectal EUS showed mucosal lesion limited to the muscularis mucosa

3.Saline adrenaline injected

4.EMR performed with snare and cautery

5.Resected specimen was retrieved.

6.Complete resection was ensured and haemostasis was secured