An Incidental Subepithelial Cecal Lesion

Subepithelial colonic lesions are common findings at colonoscopy, mostly occurring in the rectum or cecum [1]. A presumptive diagnosis can frequently be made by the endoscopic appearance and the use of a biopsy forceps. A 55-year-old asymptomatic female patient, with no relevant previous medical or family history, underwent a colorectal cancer screening colonoscopy which identified a 15-mm smooth spherical bulge in the appendicular area of the cecum (Fig. 1). Tunnel biopsies were taken with translucent fluid drainage (Fig. 2). Subsequent histologic examination revealed the presence of colonic mucosa with no dysplasia and extracellular mucus. Physical examination was unremarkable, and no significant blood test abnormalities were found. Abdominal computed tomography scan was then performed showing appendicular wall thickening with isodense content and no lymphadenopathies or peritoneal implants. A laparoscopic right hemicolectomy was performed. A 24-cm surgical specimen including 9 cm of the terminal ileum and the ileocecal appendix was