A colorectal cancer missed by colon capsule endoscopy: a case report

Abstract

Background Colon capsule endoscopy (CCE) is a non-invasive alternative to colonoscopy. The reported sensitivity and specificity of CCE for the detection of clinically significant colonic neoplasia is high. To date, there have been no reported cases of colorectal cancer (CRC) missed by CCE which were located in segments adequately visualised by the capsule. Case presentation We present the case of a 71-year-old female, who underwent CCE for new lower gastrointestinal symptoms. The CCE reported 17 polyps (largest size 10 mm) and angiodysplasia. A 40 mm caecal pole tumour, not detected by the CCE, was identified at follow up colonoscopy. Surgical resection was performed, and the pathology sample was reported as moderately differentiated adenocarcinoma, pT2 pN0 (0/19) M0, with no evidence of EMVI. The patient made an uneventful recovery. The caecal pole tumour was not definitively identified on retrospective review of the CCE images. Conclusion To date, this is the first published case of a CRC missed entirely by CCE. Further research is required to allow calculation of the post CCE interval CRC rate to allow comparison with colonoscopy and CT colonogram.

Cáncer colorrectal post-colonoscopia: Evaluación de una cohorte en sus características clínicas, colonoscópicas, sobrevida y sus causas según la Organización Mundial de Endoscopia

“…Hacia el futuro se espera la inteligencia artificial sea capaz de proporcionar un rendimiento diagnóstico de alto nivel, independientemente del nivel de habilidad del endoscopista (47) . Igualmente se esperan datos sobre el papel de la cápsula colonoscópica y su impacto en el diagnóstico certero del CCR (48,49) . Igualmente, con la expectativa de tener estudios más robustos en números y con una óptima calidad metodológica, los resultados aquí aportados pretenden contribuir a concienciar a todos los profesionales implicados sobre la relevancia de este problema y el contar con una tasa de prevalencia del CCRP local (6,9%), supone un avance para implementar las medidas para la solución del problema.…”

Advances in colon capsule endoscopy: a review of current applications and challenges

“…CCE appears to have a higher accuracy than colonoscopy for cancer, however (11,23,25,33,34). To date only one case report has been published documenting a missed cancer at complete CCE (35).…”

Colon Capsule Endoscopy in the Diagnosis of Colon Polyps: Who Needs a Colonoscopy?

“…Notably, a 40-mm cecal pole tumor, which was not detected by the CCE, was identified at follow-up colonoscopy, and this was surgically resected, thereby confirming a moderately-differentiated adenocarcinoma. The tumor was not definitively identified on retrospective review of the CCE images either [ 88 ].…”