In this series on colon cancer prevention, we would like to show some subtle lesions in colon. Here you see a flat lesion identified by the vessel cut-off sign. After injection of submucosal saline, you could identify the lesion a little bit better. Notice the changes in the surface mucosal pit pattern compared to the normal surrounding area –larger pits compared to small round pits in the surrounding area – this is a IIB flat lesion. This was removed by endoscopic mucosal resection technique using a stiff snare. It is important to grasp the lesion, and once you close the snare, it is also important to release the snare a little bit so as to avoid trapping the underlying muscularis propria. Subsequently, resection was performed and on histology you could notice a sessile serrated adenoma.
Gottumukkala S. Raju, MD, MD Anderson Cancer Center
Liben Mahometano, MD Anderson Cancer Center
Asif Rashid, MD, PhD, MD Anderson Cancer Center
Patrick Lynch, MD, MD Anderson Cancer Center