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A 52- year-old man underwent colonoscopy following preparation with polyethylene glycol- electrolyte lavage solution (PEG- ELS), which revealed a flat elevated lesion with an irregular depression in the rectum. Three days after this colonoscopy, flexible sigmoidoscopy was performed after preparation with a glycerin enema and this examination demonstrated an irregular depressed lesion which was not associated with a surrounding elevated lesion. Seven days after the flexible sigmoidoscopy, colonoscopy following preparation with PEG- ELS revealed an elevated lesion surrounding the depressed lesion. Fourteen days after this second colonoscopy, flexible sigmoidoscopy following preparation with a glycerin enema showed a depressed lesion and an endoscopic mucosal resection was performed: histological examination revealed the tumor to be a well- differentiated adenocarcinoma. We report a patient in whom PEG- ELS led to the reversible appearance of an elevated lesion around a minute rectal cancer and believe that this reactive elevated lesion might prove to be a useful clue in the detection of minute rectal cancers.
A 52- year-old man underwent a colonoscopy following preparation with polyethylene glycol-electrolyte lavage solution (PEG-ELS), which revealed a flat elevated lesion with an irregular depression in the rectum. Three days after this colonoscopy, flexible sigmoidoscopy was performed after preparation with a glycerin enema and this examination demonstrated an irregular depressed lesion which was not associated with a surrounding elevated lesion. Seven days after the flexible sigmoidoscopy, colonoscopy following preparation with PEG- ELS revealed an elevated lesion surrounding the depressed lesion. Fourteen days after this second colonoscopy, flexible sigmoidoscopy following preparation with a glycerin enema showed a depressed lesion and an endoscopic mucosal resection was performed: histological examination revealed the tumor to be well- differentiated adenocarcinoma. We report a patient in whom PEG- ELS led to the reversible appearance of an elevated lesion around a minute rectal canc er and believe that this reactive elevated lesion might prove to be a useful clue in the detection of minute rectal cancers.