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Logo of bmcgastBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Gastroenterology
BMC Gastroenterol. 2012; 12: 21.
Published online Mar 8, 2012. doi:  10.1186/1471-230X-12-21
PMCID: PMC3311598
Dome-type carcinoma of the colon; a rare variant of adenocarcinoma resembling a submucosal tumor: a case report
Masayoshi Yamada,1,3 Shigeki Sekine,2 Takahisa Matsuda,corresponding author3,5 Masayuki Yoshida,1 Hirokazu Taniguchi,1 Ryoji Kushima,1 Taku Sakamoto,3 Takeshi Nakajima,3 Yutaka Saito,3 and Takayuki Akasu4
1Pathology Division, National Cancer Center Hospital, Tokyo, Japan
2Molecular Pathology Division, National Cancer Center Research Institute, Tokyo, Japan
3Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
4Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan
5Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
corresponding authorCorresponding author.
Masayoshi Yamada: masyamad/at/; Shigeki Sekine: ssekine/at/; Takahisa Matsuda: tamatsud/at/; Masayuki Yoshida: masayosh/at/; Hirokazu Taniguchi: hitanigu/at/; Ryoji Kushima: rkushima/at/; Taku Sakamoto: tasakamo/at/; Takeshi Nakajima: tnakajim/at/; Yutaka Saito: ytsaito/at/; Takayuki Akasu: takasu/at/
Received October 20, 2011; Accepted March 8, 2012.
Dome-type carcinoma (DC) is a distinct variant of colorectal adenocarcinoma and less than 10 cases have been described in the literature. Most of the previously reported cases were early lesions and no endoscopic observations have been described so far. We herein report a case of a DC invading the subserosal layer, including endoscopic findings.
Case presentation
A highly elevated lesion in the transverse colon was diagnosed by colonoscopy in a 77-year-old man. The tumor appeared to be similar to a submucosal tumor (SMT), however, a demarcated area of reddish and irregular mucosa was observed at the top of the tumor. There were no erosions or ulcers. Laparoscopic-assisted right hemicolectomy was performed and pathological examination revealed a well-circumscribed tumor invading the subserosal layer. The tumor was a well-differentiated adenocarcinoma associated with a dense lymphocytic infiltration and showed expansive growth. The overlying mucosal layer showed high-grade dysplasia.
The present lesion was diagnosed as a DC of the colon invading the subserosal layer. Because the association of mucosal dysplasia is common in DCs, the detection of dysplastic epithelium would be important to discriminate DCs from SMTs.
Keywords: Colorectal carcinoma, Gut-associated lymphoid tissue, Dome-type carcinoma
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