Pedunculated polyps are more likely to be amenable to complete resection than non-pedunculated early colorectal cancers and rarely require additional surgery. We encountered a patient with a pedunculated early colorectal cancer that consisted of poorly differentiated adenocarcinoma with lymphatic invasion. We performed an additional bowel resection and found nodal metastasis. A 43-year-old woman underwent colonoscopy after a positive fecal occult blood test. The colonoscopist found a 20-mm pedunculated polyp in the descending colon and performed endoscopic resection. Histopathologic examination revealed non-solid type poorly differentiated adenocarcinoma. The lesion invaded the submucosa (3500 μm from the muscularis mucosa) and demonstrated lymphatic invasion. In spite of the early stage of this cancer, the patient was considered at high risk for nodal metastasis. She was referred to our institution, where she underwent bowel resection. Although there was no residual cancer after her endoscopic resection, a metastatic lesion was found in one regional lymph node. The patient is undergoing postoperative adjuvant chemotherapy, and there has been no evidence of recurrence 3 months after the second surgery. Additional bowel resection is indicated for patients with pedunculated polyps and multiple risk factors for nodal metastasis, such as poorly differentiated adenocarcinoma and lymphatic invasion. We encountered just such a patient who did have a nodal metastasis; herein, we report her case history with a review of the literature.

中文翻译：

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有蒂早期结直肠癌淋巴结转移：1例报告

有蒂息肉比无蒂早期结直肠癌更容易完全切除，而且很少需要额外手术。我们遇到了一名带蒂早期结直肠癌患者，该患者由低分化腺癌伴淋巴浸润组成。我们进行了额外的肠切除术，发现了淋巴结转移。一名 43 岁女性在粪便潜血试验阳性后接受了结肠镜检查。结肠镜医师在降结肠中发现了一个 20 毫米的带蒂息肉，并进行了内窥镜切除术。组织病理学检查显示非实性型低分化腺癌。病变侵入粘膜下层（距粘膜肌层 3500 μm）并表现出淋巴浸润。尽管这种癌症处于早期阶段，该患者被认为具有淋巴结转移的高风险。她被转诊到我们的机构，在那里她接受了肠切除术。虽然内镜切除后没有残留癌症，但在一个区域淋巴结中发现了转移病灶。患者正在接受术后辅助化疗，第二次手术后3个月无复发迹象。对于有蒂息肉和淋巴结转移的多种危险因素（如低分化腺癌和淋巴浸润）的患者，需要进行额外的肠切除术。我们遇到了这样一位确实有淋巴结转移的患者；在此，我们通过文献回顾报告了她的病史。虽然内镜切除后没有残留癌症，但在一个区域淋巴结中发现了转移病灶。患者正在接受术后辅助化疗，第二次手术后3个月无复发迹象。对于有蒂息肉和淋巴结转移的多种危险因素（如低分化腺癌和淋巴浸润）的患者，需要进行额外的肠切除术。我们遇到了这样一位确实有淋巴结转移的患者；在此，我们通过文献回顾报告了她的病史。虽然内镜切除后没有残留癌症，但在一个区域淋巴结中发现了转移病灶。患者正在接受术后辅助化疗，第二次手术后3个月无复发迹象。对于有蒂息肉和淋巴结转移的多种危险因素（如低分化腺癌和淋巴浸润）的患者，需要进行额外的肠切除术。我们遇到了这样一位确实有淋巴结转移的患者；在此，我们通过文献回顾报告了她的病史。对于有蒂息肉和淋巴结转移的多种危险因素（如低分化腺癌和淋巴浸润）的患者，需要进行额外的肠切除术。我们遇到了这样一位确实有淋巴结转移的患者；在此，我们通过文献回顾报告了她的病史。对于有蒂息肉和淋巴结转移的多种危险因素（如低分化腺癌和淋巴浸润）的患者，需要进行额外的肠切除术。我们遇到了这样一位确实有淋巴结转移的患者；在此，我们通过文献回顾报告了她的病史。