PMC6855018_01
Endoscopic image showing a submucosal nodule in the rectum at the 3 o'clock position located 12 cm from the anal verge.
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On colonoscopy, an incidental 7 mm submucosal nodule was seen in the proximal rectum at 12 cm from the anal verge (Figure 1).
Rectal endoscopic ultrasound (EUS) showing a localized hypoechoic submucosal lesion with tiny hyperechoic bands without muscularis propria invasion. Muscularis mucosae (yellow arrow), submucosa (blue arrow), and muscularis propria (red arrow).
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She then underwent an endoscopic ultrasound (EUS) of the localized submucosal lesion located 12 cm from the anal verge, at the 3 o'clock position (Figure 2).
Endoscopic image showing en-bloc cap-assisted endoscopic mucosal resection of the rectal lesion.
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An en bloc endoscopic mucosal resection with a cap and snare was achieved (Figure 3).
Endoscopic image showing successful closure of the rectal mucosal resection with two hemostatic clips.
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Two hemostatic clips were placed to close the mucosal defect (Figure 4).
Pathology images of the traumatic rectal neuroma. (a) Low-power view. Note the mucosa on the top (M), the muscularis mucosae (MM), and the submucosa (SM). The lesion contained in the submucosal (arrow). (b) High-power view of the neural cells in the submucosa comprised of haphazardly proliferating spindle cells.
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Pathology of the specimen revealed a well-circumscribed 4 mm submucosal traumatic neuroma comprised of haphazardly proliferating spindle cells consistent with Schwann cells embedded in a fibrous stroma (Figure 5).
Pathology images of Immunostaining for S100, which including spindle and epithelioid neuro cells.
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Immunostaining was positive for S100 (Figure 6).