Fig. 1.

Initial lesion resected via ESD 2 years prior. a The initial lesion resected 2 years prior via ESD was a 30 mm, Paris class 0–IIa lesion located in the cecum near the ileocal valve near the ileocal valve. b The lesion margins were delineated using 0.4% indigo-carmine dye spray, and a 4 mm 0–Is lesion was also detected near the 0–IIa lesion. c Dissected specimen, 50 × 40 mm in diameter, with both of the contained lesions having negative horizontal margins. The proximal aspect is indicated using the right direction arrow. d A low-power field image of the resected specimen of the initial lesion resected by ESD is shown. The histopathologic diagnosis was adenocarcinoma with tubular adenoma, 0–IIa, 34 × 24 mm, tub1, pTis (M), ly0, v0, pHM0, and pVM0 at a low magnification (×40). ESD, endoscopic submucosal dissection.