Risk factors for local recurrence and appropriate surveillance interval after endoscopic resection

Figure 2 Endoscopic submucosal dissection was attempted for a lateral spreading tumor-granular measuring 60 mm and was located in the ascending colon. A: However, the surgery was converted to a piecemeal resection and argon plasma coagulation was performed at the end of the procedure. The tumor histology was tubulovillous adenoma and the horizontal margin was unclear; B: After 3 mo, colonoscopy revealed a recurrent lesion and thus additional endoscopic mucosal resection was performed. Surprisingly, the histological analysis revealed mixed adeno-endocrine carcinoma T1b with indistinct margins. Thereafter, additional surgery was performed. The final depth was T3 (sub-serosal). APC: Argon plasma coagulation; EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; MANEC: Mixed adeno-endocrine carcinoma; LST-G: Laterally spreading tumor granular type.