Incidental finding of a small, pigmented lesion in the rectum of a 60 year-old man undergoing colonoscopy for colon cancer screening. Most of the lesion, shown at retroflexion, lies below the squamocolumnar junction (dentate line). As a result, biopsy was painful, and extensive tissue sampling could not be done endoscopically. Two small biopsies obtained endoscopically appeared benign, but histological interpretation was difficult due to the dense pigmentation. The lesion was therefore surgically excised, and was found to have no malignant features histologically.
Similar pigmented mucosal lesion discovered at retroflexion in the rectum in a 56 year-old woman referred for routine screening colonoscopy. Biopsy showed the lesion to be a benign blue nevus.
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