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• W2977486535 abstract "Introduction: Most gastrointestinal (GI) polyps are epithelial in origin. Some, however, are nonepithelial and include leiomyomas which are most common in the stomach and small bowel. Only 3% of all GI leiomyomas are found in the colon and rectum and constitute 1% of all GI neoplasms. We present four such cases. The first case is of an asymptomatic 52 year old man who underwent screening colonoscopy. It revealed an 11mm polyp in the descending colon that was resected using a hot snare. The second case is of a 52 year old man who underwent colonoscopy for complaints of intermittent rectal bleeding. A 4mm polyp was found in the sigmoid colon that was removed with biopsy forceps. The third case is of a 68 year old asymptomatic woman with history of polyps who underwent surveillance colonoscopy. A 6mm sessile polyp at the hepatic flexure was seen that was resected using a cold snare. The fourth case is of a 66 year old man who underwent screening colonoscopy that revealed a 6mm polyp in the rectum that was resected using a hot snare. The pathologies of these polyps were consistent with leiomyoma and had immunostain for SMA (+), CD117 (-), CD34 (-). The first patient had surveillance colonoscopy three years later that was normal. Discussion The most common sites of leiomyomas in the colon include descending and sigmoid colon. Peak incidence is in the third decade of life with a female predominance. They can present in asymptomatic individuals on screening or can have a wide variety of symptoms including bleeding, abdominal pain and intestinal obstruction. Endoscopically leiyomyomas can appear as pedunculated or intramural. They arise from the muscularis mucosa/propia, or the vascular smooth muscle and are submucosal. Diagnosis is made on histology as endoscopically they might be indistinguishable from adenomas. Wide surgical excision of the neoplasm is recommended. Up until now, there have been single case reports of leiomyomas of the colon that were endoscopically removed. Our case series has four patients with varying presentations with the tumor occurring at different locations and removed by different modalities. The high number of cases in our review suggests that the neoplasm might be more common than originally thought. No guidelines for management and follow-up of such lesions exist. We recommend that due to the neoplastic nature of such lesions, they should be followed by surveillance endoscopy. However the time interval between procedures is a matter of debate. Furthermore, we opine that for small tumors endoscopic resection, with surveillance, is appropriate as opposed to subjecting these patients to surgery. Further studies are needed to help guide in the appropriate direction to be taken." @default.
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• W2977486535 date "2012-10-01" @default.
• W2977486535 modified "2023-10-18" @default.
• W2977486535 title "Case Series of an Uncommon Colon Polyp - Leiomyoma" @default.
• W2977486535 doi "https://doi.org/10.14309/00000434-201210001-00491" @default.
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