Sp815 Rectal Cancer Developing in the Setting of a Cavernous Hemangioma in the Rectosigmoid Colon

Abstract

A 45-year-old man experienced intermittent hematochezia and anemia since age 11. For many years he was given a diagnosis of ulcerative colitis then later was treated for hemorrhoids. Eventually he was diagnosed with a cavernous hemangioma of the rectum based on MRI and colonoscopic findings. He was managed conservatively for many years with iron infusions and when needed, blood transfusions. When the patient began experiencing an increase in the amount of rectal bleeding five years after his last colonoscopy, a repeat colonoscopy was performed, which revealed the hemangioma and a 3cm polypoid mass in the distal rectum. EUS confirmed the polypoid mass involved only the superficial layers but abutted the hemangioma. Due to the concern that endoscopic removal of the polypoid mass could cause severe bleeding, our patient was referred to surgery. The hemangioma and the mass were removed surgically and the mass was found to be a T1 adenocarcinoma.