ArticleInternational journal of surgery case reports2026
Submucosal colonic hemangioma at the splenic flexure mimicking a neoplastic lesion: a rare case report and diagnostic challenge.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and aim: Submucosal tumors (SMTs) of the colon represent a heterogeneous group of lesions with variable malignant potential. Colonic hemangiomas are rare vascular tumors that are frequently misdiagnosed, often leading to delayed diagnosis and inappropriate management. They are most commonly located in the rectosigmoid region, while involvement of proximal segments, such as the splenic flexure, is exceptionally rare. We present a case of a submucosal colonic hemangioma arising at the splenic flexure, highlighting the diagnostic challenges associated with this unusual location. Presentation of case: A 50-year-old male presented with a 1-month history of painless hematochezia. Colonoscopy revealed a broad-based submucosal lesion at the splenic flexure with a positive cushion sign. Multiple biopsies were inconclusive. MRI demonstrated a 3.15 cm submucosal mass without lymphadenopathy. Due to persistent symptoms, lesion size, and uncertain diagnosis, a laparoscopic left hemicolectomy was performed. Histopathology confirmed a benign submucosal hemangioma. The postoperative course was uneventful. Clinical discussion: Colonic hemangiomas may mimic neoplastic lesions, particularly when located outside the rectosigmoid region. Preoperative diagnosis remains challenging because endoscopic biopsies are frequently nondiagnostic and may carry a bleeding risk. Although endoscopic management may be feasible in selected cases, surgical resection remains an important diagnostic and therapeutic option for symptomatic or indeterminate lesions. Conclusion: Colonic hemangiomas are rare and may mimic neoplastic lesions, particularly when located outside their typical rectosigmoid distribution. Lesions arising at the splenic flexure are exceedingly uncommon and may contribute to diagnostic uncertainty during preoperative evaluation. Surgical resection remains the preferred treatment for large or symptomatic lesions.
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