Volume 87 - 2024 - Fasc.4 - Clinical images
An unusual submucosal lesion
We report the case of a 33y old woman who underwent
upper-GI endoscopy for epigastric pain. The first
endoscopy showed a pericentimetric submucosal lesion
located on the lesser curve of the antrum. The superficial
biopsies of the lesion concluded to chronic gastritis. An
echo-endoscopy was performed to obtain new biopsies,
and showed a well-defined, hypo-echoic, submucosal
lesion of approximately 16mm. Biopsy was not possible
because of its mobility. At this point, the differential
diagnosis were leiomyoma and GIST.
To obtain a formal diagnosis through mucosal incision
assisted biopsy, a second endoscopy was performed
4 months later; the lesion had significantly grown (to
25mm), presenting as a Paris 0-Ip lesion, with superficial
ulceration (figure 1).
What is your diagnosis?
Atypical anal itching lesion associated with a protruding rectal polyp
An 83-year-old male presented at the gastroenterology
clinic with complaints of anal itching associated with a
reducible, protruding rectal mass that had been bleeding
on contact for the past few months. Clinical examination
revealed two erythematous, slightly nodular, eczema-like
lesions measuring 3 cm and 2 cm, extending laterally
from the anal margin. (Figure 1, Panel A) A digital rectal
exam revealed a small, soft mass in the posterior lower
rectum. Total colonoscopy identified a 25 mm sessile
polyp classified as CONECCT 2C (1) in the lower rectum
(Figure 1, Panel B). Biopsies of the anal margin lesions
were obtained using a cold forceps.
