Primary ad hoc tip-in mucosectomy for colitis-related erythema-like dysplasia (with video)

A 69-year-old male patient was referred for anemia workup related to his long-standing Crohn’s ileocolitis. The patient was in clinical remission on standard-dose ustekinumab and had undergone ileocecal resection >10 years ago. Ileocolonoscopy was significant for mildly active disease in the proximal colon (thus not qualifying for panchromocolonoscopy), as well as for a suspicious, estimated 15-mm erythema-like lesion in the sigmoid colon (A). More close-up views on narrow-band imaging revealed an amorphous surface and altered vessel pattern indicated by condensed brownish spots, suggesting a neoplastic colorectal lesion (B).