A man in his 40s with ulcerative colitis was noted to have a reddish protuberant lesion with depressed surface on the Bauhin valve. At first glance, this lesion was diagnosed colorectal cancer with submucosal invasion because the white light imaging showed submucosal tumor-like elevation. However, since there was no evidence of epithelial tumor on detailed magnified endoscopy, we thought that inflammatory fibrous polyp or pyogenic granuloma was more likely, so underwater EMR was performed. Pathological examination revealed a diagnosis of pyogenic granuloma. We report here a case of pyogenic granuloma that required differentiation from malignancy.
