An Unusual Cause of Hematochezia

An 85-year-old man presented with scanty rectal bleeding. Physical examination was unremarkable, apart from a palpable mass on digital rectal examination. He underwent a colonoscopy that showed a 30-mm pedunculated polyp with unusual morphology in the distal rectum, near the anal margin (Figure A). After adequate lifting with a saline, indigo-carmine, and adrenaline solution, the lesion was removed en bloc using a diathermic snare and sent to pathology (Figures B and C). Histopathology described a polypoid lesion with diffuse infiltration of large, pleomorphic tumor cells (Figures B and C).
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Electronic image of the month Source Type: research