Subserosal recurrence without mucosal involvement diagnosed 5 years after endoscopic submucosal dissection for early rectal cancer

Abstract

A 61-year-old woman underwent successful en bloc endoscopic submucosal dissection (ESD) for the management of a 4-cm, nodular, mixed-type, laterally spreading tumor located 11 cm from the anal verge ([Fig. 1]). Although the depth of submucosal invasion was 3000 μm, the patient refused additional surgical treatment. Three weeks after ESD, the patient developed an extraperitoneal pelvic abscess, which was caused by delayed rectal perforation and required percutaneous drainage.