Colonoscopy - Melanosis masquerading as cancer

A case of a middle aged patient who underwent colon cancer screening. During colonoscopy a lesion in the cecum was found and interpreted as a cancer. A snare resection and a tattoo were performed.

Histopathological examination revealed no cancer (just melanosis coli), however an hemicolectomy was recommended to a patient.

The patient came for a second opinion. Detailed white light examination revealed normal mucosal pit pattern, healed scar, and a tattoo; the findings were confirmed on narrow band imaging as well as Methylene Blue Chromoendoscopy. Biopsy confirmed melanosis coli and the patient was relieved. Surgery is not needed for this lesion as it is not precancerous.