Images in Clinical Medicine
Progression of a Pedunculated Polyp
N Engl J Med 2006; 355:1912November 2, 2006
- Article
A 56-year-old man underwent a colonoscopy after a positive fecal occult-blood test. Colonoscopy revealed two pedunculated polyps, one in the ascending colon and one in the transverse colon. One polyp was removed with a polypectomy snare (Panel A), but removal of the other was deferred owing to procedural difficulties. Unfortunately, the patient did not return for follow-up, for personal reasons. Five years later, he returned to our hospital after another positive fecal occult-blood test. Colonoscopy revealed a lesion, 15 mm in diameter, at the site of the previously detected pedunculated polyp (Panel B); no additional polyps were found. Complete surgical resection of the lesion was successful. Histologic evaluation revealed a moderately well-differentiated adenocarcinoma with nodal involvement, stage IIIA (T3N1M0), that had invaded the subserosa. He remained free of disease at 1 year.
Kuangi Fu, M.D., Ph.D.
Yasushi Sano, M.D., Ph.D.
National Cancer Center Hospital East, Kashiwa, Chiba 288-8577, Japan
fukuangi@hotmail.com
