Deep invasive mucinous adenocarcinoma without surface amorphous pattern on inflammatory bowel disease: specific disease with specific characterization

Endoscopic characterization of deep invasive carcinoma using current classifications (CONECCT III, JNET III, NICE III) is effective but was not developed for neoplasias associated with inflammatory bowel diseases (IBDs). In IBD, dysplastic lesions often present as flat, non-granular laterally spreading tumors (LST-NGs) [1] [2]. However, mucosal distortion caused by chronic inflammation and regenerative changes can conceal dysplasia, making the detection and characterization of the colonic lesions challenging [3] [4]. The present case illustrates that deep invasive adenocarcinoma can occur with very slight mucosal changes in an IBD lesion ([Video 1]).