Pyogenic granuloma of the descending colon.

have large hepatic cysts presented with a positive fecal occult blood test. Her phys− ical examination was unremarkable, and laboratory testing revealed no abnormal− ities. A double−contrast barium study showed a round, radiolucent area in the descending colon. Colonoscopy revealed a light−red, sessile lesion, about 15 mm in diameter, which consisted of variously− sized nodules covered with white exu− date (l" Fig. 1). The rest of the colonic mucosa was unremarkable. When the specimen was biopsied massive bleeding occurred, suggesting that the lesion was hypervascular. Histological examination of the biopsy specimen showed prolifera− tion of capillaries. The lesion was resected and the large hepatic cysts were drained during the same laparoscopic procedure. Histo− logically, the surface was found to be cov− ered by foci of regenerating epithelium (l" Fig. 2). High−power magnification showed that the tumor was composed of numerous capillaries which were lined with plump endothelial cells, with an edematous stroma containing acute and chronic inflammatory cell infiltrates (l" Fig. 3). There were also so−called “satellite” lesions [1] in the muscularis propria layer and in the subserosa (l" Fig. 4). On the basis of these findings, the tumor was diagnosed as a pyogenic granuloma. One year later, no evidence of recurrence was found on follow−up colo− noscopy, and she reported no gastrointes− tinal symptoms. Pyogenic granuloma is a benign lesion, al− though recurrence has been reported [2]. It occurs extremely rarely in the gastroin− testinal tract, and only 20 cases have been reported in the literature [3± 5]. With re− spect to treatment, both surgical and en− doscopic resection methods have been described. Because this patient also re− quired treatment for her large hepatic cysts, laparoscopic resection was the best option in this case. To our knowledge, this is the first report of pygenic granuloma in Pyogenic granuloma of the descending colon