Nodular lesion of distal rectum of unknown aetiology? Case report

Abstract

Transanal endoscopic microsurgery is currently a method of choice for adenomas located up to 20 cm from the anal verge. Solitary rectal ulcer syndrome is a condition treated with, among other things, full-thickness resection. The aim of the study was to assess the efficacy of this treatment approach for a nodular rectal mass. Although the lesion was classified as low-grade dysplasia, after full-thickness excision it turned out to be a solitary rectal ulcer. We present a case of a 39-year-old woman chronically treated for haemorrhoidal disease and incomplete rectal prolapse. Due to an uncertain clinical picture and low-grade dysplasia confirmed by histopathological examination, a decision was made to perform a full-thickness transanal excision. The procedure was successful. The wound was closed with a continuous, absorbable suture. A follow-up colonoscopy showed no signs of recurrence, as confirmed by scar tissue biopsy. The hospital stay was uneventful and there were no signs of incontinence. Transanal endoscopic microsurgery is a safe and effective approach in properly qualified patients. No complications affecting the quality of life, recurrences, or other incontinence-related complications were observed in the patient. Proper qualification allowed for full recovery and a final diagnosis.