Case report; A diagnostic dilemma caused by the presence of ORISE gel, when not removed with initial endoscopic en‐bloc resection

Abstract

The submucosal cushion product ORISE gel enhances the visibility and resectability of small lesions at endoscopic mucosal resection. However, the presence of this product in tissue, when not resected with initial polypectomy, sometimes presents a diagnostic dilemma to the clinician as well as the pathologist. We present a case report of residual submucosal gel underlying a tubular adenoma in a segmental transverse colon resection. The granuloma formation beneath the underlying tubular adenoma along with residual ORISE gel, appeared a a mass to the clinician, and presented a diagnostic challenge to the pathologist in the frozen section evaluation without clinical history.