Endoscopic submucosal dissection of an atypical rectal submucosal lesion: a rare case of a large digestive angiodyplasia of exclusive submucosal presentation

We report here the case of a 37-year-old patient without comorbidities referred to our unit for endoscopic submucosal dissection (ESD) resection of a submucosal lesion of the lower rectum. The lesion measured 40 × 30 mm and did not present any mucosal abnormality ([Fig. 1], [Fig. 2]). An echo-endoscopy was performed prior to resection, showing an atypical anechogenic duct within the lesion ([Fig. 3]) without clear blood flow on Doppler analysis, which initially led to the suspicion of an ectopic gland or a fistulated rectal gland.