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hematochezia. Colonoscopy revealed an approximately 3-cm pedunculated polyp with a long stalk, at 14 cm from the anal verge. The head of the polyp had a multilobular appearance but no ulceration. The stalk was thin and smooth (●" Fig. 1a). The lesion was resected using standard polypectomy techniques and retrieved in its entirety. Histology showed that the cut end of the stalk was completely negative, and one of the four sections demonstrated subtle invasion into the submucosal layer of the head of the polyp (●" Fig. 2a). Tumor cells in this area resembled a low-grade adenoma (●" Fig. 2b). No lymphovascular invasion, no areas of poor differentiation, andno tumorbuddingwerepresent. Additional surgery was not indicated, and the patient accepted this decision. At follow-up1 year and 4months later, the polypectomy sitewas easily identified due to previous tattooing. The tattooed normal mucosa adjacent to the polypectomy site seemed slightly elevated (●" Fig. 1b) although this finding was not appreciated at that time. At repeat follow-up 2 years and 8 months after presentation, an apparent tumor with ulcerationwas detected at the polypectomy site, identified by the previous tattoo (●" Fig. 1c). Surgical resection was then carried out, and the specimen showed pure mucinous adenocarcinoma, with pathologic T3N1 staging. The original paraffin-embedded specimenwas cut further for immunohistochemistry studies. An expert pathologist reviewed the histologic findings. However, the present case did not possess any unfavorable histology [1–5]. To the best of our knowledge, this is the first description of a pedunculated polyp Recurrence after polypectomy for a pedunculated polyp with subtle invasion but no unfavorable histology