Case of Colorectal Cancer After Cold Snare Polypectomy Successfully Salvaged on Endoscopic Submucosal Dissection

Abstract

Cold snare polypectomy is a well-established method for the resection of colorectal polyps measuring less than 10 mm in size. It may be performed in patients with early colorectal cancers because of the difficulty of endoscopic diagnosis. However, the therapeutic effect of cold snare polypectomy on cancers is unknown, and the need for appropriate surveillance and additional treatment for these patients remains to be fulfilled. Endoscopic submucosal dissection has been reported as a safe and effective method for treating recurrent or residual colorectal neoplasia following hot endoscopic mucosal resection. This report is of a case of a colorectal tumor measuring 8 mm that was treated using cold snare polypectomy and resulted in residual cancer. Endoscopic submucosal dissection was selected as salvage treatment for the residual lesion, and histopathological examination revealed free horizontal and vertical margins. We believe that performing endoscopic submucosal dissection at the site of the cancer resected with cold snare polypectomy ensured that there was no residual cancer left. It may be hypothesized that endoscopic submucosal dissection could evolve as the treatment of choice for patients with colorectal cancer after cold snare polypectomy.

Invasive Colon Cancer Inadvertently Resected by Cold Snare Polypectomy

“…Therefore, if careful observation of white-light endoscopy had been performed, inappropriate CSP could have been avoided. Several cases of inadvertent treatment of diminutive cancerous polyps with CSP have been reported (17,18). However, the management of such cases remains controversial, as there is no robust evidence supporting appropriate salvage and surveillance methods.…”

“…Several cases of inadvertent treatment of diminutive cancerous polyps with CSP have been reported ( 17 , 18 ). However, the management of such cases remains controversial, as there is no robust evidence supporting appropriate salvage and surveillance methods.…”