A Case of Serrated Adenoma Presenting as Colon Cancer / 대한소화기내시경학회지

Serrated adenoma (SA) is a distinct form of colorectal neoplasia and it is defined as a neoplastic lesion composed of a monotonous cell population with atypical nuclei proliferating in serrated glandular architectures. Hyperplastic polyp is considered a benign lesion with no malignant potential. However, SA progressed into frank carcinoma has been demonstrated in an individual case, and 'serrated neoplasia pathway' is suggested by some authors as an alternative to classical adenoma-carcinoma sequence. Distinguishing between hyperplastic polyp and SA is important because of the different management implications and the increased potential for neoplastic progression in the latter, but sometimes it is very difficult. SA is usually small and sessile polypoid lesion. We report a case of SA presenting as large fungating mass similar to colon cancer, diagnosed as hyperplastic polyp initially by colonoscopic biopsy and confirmed as after SA the surgery.

A Case of Abdominal Actinomycosis / 대한소화기내시경학회지

Actinomycosis is a chronic suppurative and granulomatous disease caused by actinomyces species and caracterized by sulfur granule formation which frequently discharged via draining sinus. Actinomyces can affect cervicofacial, pulmonary, abdominal and pelvic area. Most of abdominal actinomycosis is developed after abdominal operation, trauma or inflammatory bowel disease and it must be differentiated from colon cancer, amaeboma, chronic appendicitis or intestinal tuberculosis. We report a case of abdominal actinomycosis, preoperatively impressed as colon carcinoma, which was diagnosed by histological study of the operative specimen. Adequate surgical excision and drainage procedure followed by administration of massive dose of penicilline for weeks. In this case we noted secondary abscess formation after surgery of primary disease. Herein we present our experience with reviewed literatures.