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Laterally spreading tumours (LSTs) of the colon and rectum are defined as lesions greater than 10 mm in diameter with a low vertical axis that extend laterally along the luminal wall.1 As most LSTs remain as adenomas or early invasive cancers, LSTs have been thought to have relatively little malignant potential. LSTs are divided into two macroscopic subtypes: flat (F)-type, which is composed of superficially spreading lesions with flat and smooth surfaces, and granular (G)-type, which is composed of superficially spreading aggregates of nodules.2 Despite distinctive biological behaviours of LSTs, only a few genetic alterations have been reported, such as K-ras and p53 mutations3,4 and cyclooxygenase 2 overexpression.5
A 62 year old Japanese woman was referred to our hospital for treatment of a colonic tumour. Colonoscopy in our hospital showed an F-type LST with a central depression surrounded by a flat elevated area with a smooth surface in the …
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Conflict of interest: None declared.