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A 76−year−old man was referred to our en− doscopic unit with hematochezia and an− emia. He had been receiving palliative treatment, including radiation therapy, for a primary stage IV parotid gland can− cer. Colonoscopy showed that the mucosa of the terminal ileum had prolapsed into the colonic lumen, and a flat elevated le− sion, 8 mm in diameter and mimicking a small flat adenoma, was seen on the pro− lapsed ileal mucosa (Figure 1). On palpa− tion with biopsy forceps, the lesion felt more solid and harder than an ordinary adenoma. An endoscopic biopsy sample was sent for histological evaluation, and the findings were consistent with a meta− static parotid gland cancer (Figure 2), the histological features being quite similar to those of the primary tumor biopsied previously. No definite source of bleeding was detected on upper and lower gastro− intestinal endoscopic examinations. Pal− liative treatment was continued and the patient died 4 months later.

An ileal metastasis from a parotid gland cancer that mimicked a flat adenoma