An uncommon polyp in the colon: a pedunculated cavernous hemangioma

Colonoscopy was performed in a 40-year-old man, who was referred by his primary care physician because of abdominal pain. This examination revealed a smooth, blue-colored polyp with a diameter of 30 mm on a long stalk, situated in the transverse colon ([Fig. 1]). There were no other abnormalities in the large intestine.

Fig. 1 Polyp with smooth surface located in transverse colon.

The polyp was successfully removed by snare polypectomy. There was no blood loss during the removal of the polyp, but once outside the patient the mass appeared to be filled with blood and emptied itself ([Fig. 2]).

Fig. 2 Polyp after snare diathermy.

Histological examination showed a polyp with normal colonic mucosa at the surface and, underneath, in the submucosa, dilated vascular structures covered by endothelium without nuclear polymorphism. The vascular spaces were filled with blood. There were no signs of inflammation ([Fig. 3]).

Fig. 3 Histological section showing normal colonic mucosa at the surface and dilated vascular structures filled with blood (hematoxylin and eosin, original magnification × 40).

It was concluded that this was a pedunculated colonic polyp with cavernous hemangioma.

A PubMed search of the literature revealed three articles on colonic polyps with cavernous hemangioma [1] [2] [3], one of which was in Korean and was not accessible to us. The presenting complaints of the patients described in the other papers were rectal bleeding and pain. The polyps were removed by snare polypectomy without complications, as in the case of our patient.

Endoscopy_UCTN_Code_CCL_1AD_2AC

References

• 1 Cho E Y, Choi S C. The cavernous hemangioma of the colon inducing massive hematochezia and treated by endoscopic polypectomy.  Korean J Gastroenterol. 2005;  45 379-380
• 2 Liang L C, Forbes N, David J, Ozick L. Endoscopic polypectomy of an unusually long polypoid colorectal cavernous hemangioma.  Gastrointest Endosc. 1998;  47 307-308
• 3 Amano K, Seko A, Nagura K. et al . A case of polypoid cavernous haemangioma of the sigmoid colon excised by colonoscopic polypectomy.  Gastroenterol Jpn. 1993;  28 712-718