A case of a 20 mm colonic leiomyoma treated by endoscopic resection

Abstract

A 64-year-old man was admitted to our hospital for further investigation of a colonic submucosal tumor. Colonoscopy revealed a submucosal tumor of about 20 mm diameter in the descending colon. Magnifying endoscopy showed normal pit pattern (typeI) . Endoscopic ultrasonography demonstrated that the hypoechoic tumor originated from the second layer of the colonic wall. The patient had complained of intermittent abdominal pain and it was suspected that the tumor was resulting in bowel obstruction, so complete resection was performed. In this case, minimally invasive treatment was recommended as the patient was suffering from myocardial infarction, type II diabetes mellitus and bladder cancer. The tumor was removed endoscopically─without submucosal injection─succeeded by en bloc resection without complication. The final pathological diagnosis of the tumor was a leiomyoma. According to previous reports, many such cases are treated by surgical resection. In this case, the patient had several pre-existing conditions and we therefore elected to treat by endoscopic resection in order to minimize risks to him.