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Should you trust the radiologist?
  1. Sun Mi Ha,
  2. Donal Sheehan,
  3. Ahmed Shalabi,
  4. Malcolm A West,
  5. Rajapandian Ilangovan,
  6. Morgan Moorghen,
  7. John T Jenkins,
  8. Siwan Thomas-Gibson
  1. St Mark's Hospital and Academic Institute, Harrow, UK
  1. Correspondence to Dr Sun Mi Ha, St Mark's Hospital and Academic Institute, Harrow HA1 3UJ, UK; s.m.ha{at}

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A colonoscopy was performed in a 65-year-old asymptomatic patient with a positive faecal immunochemical test. Their only medical history was well-controlled asthma.

The colonoscopy was performed by an experienced bowel cancer screening endoscopist. The examination found a lumen-filling lesion in the ascending colon (figure 1) just downstream to the ileocaecal valve. The lesion was hard to touch and biopsies were taken. The appearance was compatible with an eroding submucosal lesion. The endoscopist informed the patient of the likely diagnosis of cancer, and requested urgent imaging.

Figure 1

Endoscopic view of ascending colon.

The case was discussed in the Complex Polyp …

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  • Contributors ST-G performed the colonoscopy and was responsible for the patient's clinical care. JTJ and MAW performed the surgery and provided surgical images. RI gave the radiological opinion and provided radiological image. MM reported the histology and provided histology images. SMH coordinated, wrote the manuscript and adjusted the images. DS and AS critically revised the manuscript. All had input on final draft of document.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.