Master, Doctor Nguyen Van Son, from the Department of Gastroenterology at Tam Anh Cau Giay General Clinic, performed a colonoscopy on Ms. Vuong. During the procedure, the team noted and removed two polyps, measuring 8 mm and 4 mm, from her ascending colon. Further examination of the cecum (the beginning of the large intestine, located at the junction of the small intestine and appendix) revealed an abnormal lesion at the base of the appendix.

This lesion measured approximately 1,8-2 cm, had a villous surface, and was located deep within the appendix lumen with unclear boundaries. Magnified endoscopic images showed abnormal microvessels, classified as group 2B. Doctor Son explained that, based on the JNET classification (a system for colorectal lesion classification), these findings suggested a precancerous lesion or early-stage cancer.

The colonoscopy team discovered a high-grade dysplastic lesion at the base of the appendix in the patient. *Photo: Tam Anh General Hospital*

Subsequent biopsy results confirmed the lesion at the appendix base was an adenomatous polyp with high-grade dysplasia – a form of precancerous lesion. The two colon polyps removed earlier were benign.

"Ms. Vuong's polyp, nearly 2 cm and with high-grade dysplasia, may have been silently developing for many years," Doctor Son stated. He added that appendix polyps are rare lesions, mostly discovered incidentally after an appendectomy due to their challenging location. As the lesion could not be completely removed through endoscopic intervention, doctors considered surgery for the patient.

Colorectal polyps and many precancerous or early-stage cancerous lesions often present with no clear symptoms, making them easily overlooked. Doctor Son recommends that individuals over 45 years old undergo screening colonoscopies as advised to avoid missing such conditions.

Patients should seek examination, diagnosis, and timely treatment when experiencing signs such as: blood in stool, prolonged changes in bowel habits, persistent constipation or diarrhea, or unexplained intermittent abdominal pain.

Ly Nguyen

*Patient's name has been changed*