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Background: Rectal leiomyoma is a rare histological entity withnonspecific appearance on endoscopy and scarce literature regarding its management.The paucity of available literature is likely due to its benign behavior, and treatment is only indicated for symptomcontrol. As such, there are manyunknowns regarding polypectomyeffectiveness as a treatment and whether it is necessary to monitor after excision.Here, we review published cases of rectal leiomyoma and itsproposed endoscopic treatments and outcomes. Case Summary: We report a case of a rectal leiomyoma diagnosed after endoscopic resection of a rectal sessile polyp. A 70-year-old woman with longstanding diabetes was referred for further investigation of chronic constipation and recurrent anal abscess. Colonoscopy revealed a 7-mm sessile polyp in the rectum. Polypectomy was performed using a cold snare, and histology confirmed a rectal leiomyoma and an R0 resection. No bleeding and no residual local lesions were found on control endoscopy. Conclusion: R0 endoscopic resection is an effective, low-risk treatment for rectal leiomyoma, and no follow up is required.

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