Extensive rectal adenoma

Prof. Pradeep Bhandari


Solent Centre for Digestive Diseases, Queen Alexandra Hospital Portsmouth, UK

Patient information /  Indication

An 80-year old man was referred for endoscopic mucosal resection of a 10 cm rectal adenoma. His main symptom was debilitating mucous discharge and diarrhoea. He had multiple cardiac co-morbidities that prevented curative surgical resection. The endoscopic assessment was performed to exclude foci of cancer.

Methods & Results

By using the Fujifilm 700 series gastroscope (EG-760R) the extensive adenoma was visualised encompassing 100 % of the luminal circumference.
Figure 1 is the white light image. BLI did not reveal any evidence of invasive vascular pattern (Figure 2). LCI highlighted the villous nature of the polyp (Figure 3, 4).


Giant polyps have a high risk of cancer and are usually not suitable for endoscopic resection. BLI assessment allowed us to confidently exclude malignancy in this case and consider endoscopic resection.

Figure 1
Figure 2
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Figure 4