Her oncologist in Seattle hinted that it might be too late to operate, and that surgery could even make matters worse by spreading tumor cells around inside her body.
Conventional endoscopic treatment of a recurrent adenoma after piecemeal EMR (PEMR) of a colorectal laterally spreading tumor (LST) is technically difficult with low en bloc resection rates because of the inability to snare fibrotic residual.
LST-G-MIX: laterally spreading tumors, granular, nodular mixed type; LST-NG-F: laterally spreading tumor, non-granular, flat elevated type; LST-NG-PD: laterally spreading tumor, non-granular, pseudo-depressed type.
LST: Laterally spreading tumor; LST-Gs: Granular-type LSTs; NBI: Narrow-band imaging; MC: Vessels, meshed capillary vessels; IEE: Image-enhanced endoscopy.
While tumor cell intrinsic factors can enhance metastatic efficiency and site selection [ 1], metastasis also relies on interactions between spreading tumor cells and host factors in the target organ [ 2].
The latter usually presents as flat or depressed tumors and is further subcategorized into depressed type, flat tumor less than 1.0 cm (0-IIa) and laterally spreading tumor (LST).
