Adenoma - flat 1
A 57-year-old white male was found on several occasions to suffer from iron deficiency anemia. He had undergone gastroscopy and colonoscopy three years earlier. The current referral was for capsule endoscopy. Although the patient had undergone a diagnostic work-up three years earlier, the patient underwent repeat colonoscopy prior to capsule endoscopy.
The videoclip shows the middle sigmoid colon. There is a very flat tumor covering over half of the circumference and several folds. The blood vessels in the mucosa extend into the tumor and are there no longer visible. Biopsies obtained from several regions of the tumor showed a tubular adenoma with no evidence of dysplasia.
It is probable that the tumor was already present three years earlier. Flat and small changes are easily missed. An experienced endoscopist can perform mucosectomy to remove such a lesion. With lesions of this size, however, surgical resection is also justifiable.