COULD THE ENDOSCOPIC RESECTION OF A LARGE RECTAL LEIOMYOMA BE AN EFFETCIVE AND SAFE TECHNIQUE?

Summary. Rectal leiomyomas are a rare conditions, with low reported incidence in literature and constituteabout 0.1% of rectal tumours; in fact rectal leiomyomas occur in approximately 1 out of 2000-3000 rectaltumors. We report on a patient with a 3 cm semi-pedunculated colonic leiomyoma, which was successfullyremoved by endoscopic polypectomy after normal saline-epinephrine submucosal injection. When we encountera tumor during a colonoscopic examination, we usually evaluate the tumor carefully and perform anendoscopic resection when we judge it is appropriate. When a symptomatic smooth muscle tumors smallerthan 2 cm are incidentally found on colonoscopy, surgical resection is unnecessary. Furthermore, if a tumorcan be lifted with a snare and it is either pedunculated or semi-pedunculated, endoscopic resection might be asafe option. For those tumors with wide-based or exoluminal growth, endoscopic removal should be avoideddue to the higher risks of bleeding and perforation. The histological findings of the resected tumor are important.If there is any malignant element that can not be completely eradicated, we would suggest surgicaltreatment. We believe our process allows to avoid unnecessary surgery and reduces medical costs.