Endoscopic Removal of Pedunculated Leiomyoma of the Sigmoid Colon.

Background: The large bowel is a rare site for leiomyomas. Furthermore, a colonic pedunculated leiomyoma is very rare. Complete endoscopic removal of a colonic leiomyoma can be problematic because of its submucosal origin.

Case report: We report a colonic pedunculated leiomyoma that was removed by endoscopic polypectomy without complications. A 74-year-old man was referred to our hospital because of constipation. Colonoscopy demonstrated a 1-cm pedunculated polyp that was connected to a minute stalk within the sigmoid colon. It was removed by snare polypectomy. Histopathological examination demonstrated normal mucosa overlying a well-circumscribed proliferation of eosinophilic spindle cells arising in association with the muscularis mucosae. Immunohistological findings were positive for desmin and smooth muscle actin. The polyp was diagnosed as a leiomyoma. More than 9 months later, the patient remains well, with no further symptoms.

Conclusion: For small, pedunculated leiomyomas, endoscopic snare polypectomy is thought to be a useful approach for both treatment and diagnosis.