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A 72-year-old man was referred by the GP to the colorectal unit on the fast track pathway for asymptomatic iron deficiency anaemia (haemoglobin 88 g/L). A diagnostic colonoscopy reported complete intubation to caecum and identified three colonic polyps with villous appearance, the largest in the sigmoid measuring 6 cm. A CT scan of the abdomen and pelvis reported the presence of the large sigmoid polyp and no other abnormality. The patient attended a specialist endoscopy list for therapeutic polypectomy. The examination of the caecal pole by the expert endoscopist revealed an unusual and abnormal appearance described as a tense submucosal cystic swelling protruding into the lumen in the area of the appendix orifice, not recorded at the first examination (figure …
Contributors MTP cared for the patient, performed the colonoscopy and the surgery and wrote the manuscript. SM cared for the patient, researched literature and cowrote the manuscript. RK researched the literature and cowrote the manuscript. JC performed the histopathology examination and reviewed the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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