A case of a recurrent sessile serrated adenoma/polyp surrounding the appendiceal orifice developing 1 year, after EMR

Abstract

A 61-year-old man presented to our hospital with abdominal pain and hematochezia. No abnormal findings were noted on laboratory examination, while total colonoscopy revealed a sessile discolored 20-mm polyp with a granular surface in the cecum. Endoscopic piecemeal mucosal resection (EPMR) of the polyp was performed. Pathological examination indicated findings consistent with a sessile serrated adenoma/polyp (SSA/P) . A follow-up colonoscopy performed after 1 year revealed a sessile lesion around the appendiceal orifice and a biopsy examination indicated findings consistent with a SSA/P, similar to the EPMR specimen. The lesion was judged to be endoscopically unresectable, therefore, laparoscopic excision was performed. The patient exhibited a good clinical course after the surgery, and showed no furtherrecurrence. Thus, we report a rare case of relatively early recurrence of an SSA/P surrounding the appendiceal orifice.