Abstract

Endoscopic mucosal resection is accepted standard treatment of early gastrointestinal cancer, defined as cancer with involvement confined to the mucosa without lymph node metastasis. Under the therapeutic endoscopy, submucosal saline injection minimize the risks of transmural burn, perforation, bleeding. As laparoscopic colectomy became popular recently, colonoscopic tattooing of lesions to assist for localization in surgical field is in the spotlight. Four submucosal saline injections around the lesion, performed with an injection needle to test for the possibility of EMR, showed an obvious 'non-lifting sign'. Therefore we performed endoscopic tattooing, and then experienced tumor cell seeding on tattooing site. Manipulation of cancerous tissue with submucosal saline injection or tattooing can have a risk of tumor cell seeding on injection sites at any time. Furthermore, if bowel wall is perforated, peritoneal metastasis or seeding are possible. In this case, we approached and injected saline carefully for prevention of cancer penetration. (Intestinal Research 2005;3:150-153)

• Keywords: Endoscopic mucosal resection, Tattooing, Seeding, Cancer