Table 4 Characteristics of malignant lesions excised using TAMIS
From: Transanal Minimally Invasive Surgery (TAMIS) in Qatar: initial experience
No | Age group/sex | Location (cm) | Pre-operative HP | Colonoscopy findings | MRI findings | Indication | Tumor size (cm) | Post-operative HP | Need for further management |
|---|---|---|---|---|---|---|---|---|---|
1 | 55–65 / S1 | 5 | Moderately differentiated adenocarcinoma (reaching inked margin) | Sessile polyp in the rectum (snared) | No gross lesion found | Treatment | 2.2 × 1.7 | pT0, no residual; tumor | None |
2 | 55–65 / S1 | 10 | Tubulovillous adenoma | Flat polyp | Lesion in mid-rectum confined to muscularis propria | Treatment | 2.3 (cancer 2 mm) | Polyp Moderately differentiated adenocarcinoma (Haggit’s 1) | None |
3 | 85–95 / S1 | 3 | Moderately differentiated adenocarcinoma (cT2 / early T3 N0 M0) | Ulceroproliferative lesion in the rectum | No MRI. EUS showed T2 / early T3 | Treatment, patient unfit for radical resection | 3.9 × 2.3 | Moderately differentiated adenocarcinoma (pT2) | None |
4 | 35–45 / S1 | 4 | Moderately differentiated invasive adenocarcinoma, arising in a tubular adenoma with high-grade dysplasia | 2 cm rectal lesion (infiltrating the mucosa) | Definite polypoidal lesion at the lower rectum T1/T2 with thickened CRM | Treatment | 1.5 × 0.7 | Tubular adenoma with high-grade dysplasia | None |
5 | 75–85 / S2 | 3 | Villous adenoma with at least high-grade dysplasia and suspicions cancer | Rectal mass with query malignant features | No MRI. EUS: T3 lesion | Treatment | 3 × 2 × 0.5 | Moderately differentiated adenocarcinoma cT1N0M0 | None |
6 | 35–45 / S1 | 10 | Well differentiated adenocarcinoma on tubulovillous adenoma (incomplete colonoscopic removal) | Large rectal polyp 10 cm from anal verge, with broad base. Removed incompletely in fragments | Lesion in the upper rectum could not be clearly appreciated because of metallic clips placed after polypectomy | Treatment | 4.5 × 3.6 × 2 | Residual well differentiated adenocarcinoma on tubulovillous adenoma (SM3) | None |
7 | 55–65 / S1 | 10 | Tubulovillous adenoma with focal high-grade dysplasia | Sessile polypoid lesion with central depression, about 1.5 cm in size, at 10 cm from anal verge | Right posterolateral polypoidal wall thickening measuring approximately 15 mm, with central hyperintensity; no significant diffusion restriction or hyperenhancement. No extension beyond the muscularis. | Treatment | 2.5 × 1.7 × 1.8 cm | Moderately differentiated invasive adenocarcinoma with mucinous component in a background of tubulovillous adenoma with focal high grade dysplasia. Kikuchi SM2 | None |