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Progression of a Pedunculated Polyp
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     A 56-year-old man underwent a colonoscopy after a positive fecal occult-blood test. Colonoscopy revealed two pedunculated polyps, one in the ascending colon and one in the transverse colon. One polyp was removed with a polypectomy snare (Panel A), but removal of the other was deferred owing to procedural difficulties. Unfortunately, the patient did not return for follow-up, for personal reasons. Five years later, he returned to our hospital after another positive fecal occult-blood test. Colonoscopy revealed a lesion, 15 mm in diameter, at the site of the previously detected pedunculated polyp (Panel B); no additional polyps were found. Complete surgical resection of the lesion was successful. Histologic evaluation revealed a moderately well-differentiated adenocarcinoma with nodal involvement, stage IIIA (T3N1M0), that had invaded the subserosa. He remained free of disease at 1 year.

    Kuangi Fu, M.D., Ph.D.

    Yasushi Sano, M.D., Ph.D.

    National Cancer Center Hospital East

    Kashiwa, Chiba 288-8577, Japan

    fukuangi@hotmail.com