LAUSR

A xanthoma is a benign lesion consisting of foamy cells characterized by a highly vacuolated cytoplasm. Such lesions can develop anywhere in the gastrointestinal tract but most often occur in the stomach, duodenum, or esophagus and very rarely in the colon [1]. Gastric xanthoma shows a high incidence in gastric cancer patients and is reportedly an independent predictor of gastric cancer [2]. Although adenomas associated with colorectal xanthoma were first reported in 1997, clear evidence supporting an association between xanthoma and colorectal adenoma or cancer is lacking [3]. Furthermore, the association between adenoma and lipid deposits is unproven, and although adenoma has been found adjacent to or around xanthoma, this is more likely coincidental. Colorectal xanthomas are rare benign lesions with a small polypoid appearance and located mainly in the rectosigmoid area [4]. Here, we report a case of adenoma arising within a xanthoma treated with endoscopic submucosal dissection. The lesion reported in our case was distinguished from those in previous reports by its large size (>5 cm), atypical gross findings (laterally spreading), and unusual site (transverse colon). Accordingly, we report a case of xanthoma with an unusual gross finding along with a literature review.