Tubular Adenoma Arising Within a Rectosigmoid Xanthoma: A Case Report

Colonic xanthomas are a rare finding, particularly when combined with a tubular adenoma in a single polyp. While transformation to malignancy is not thought to be higher than that of a tubular adenoma alone, there is still concern as to the pathophysiology of xanthoma formation within the colon and what that may mean for patient outcomes. Here, we present a patient undergoing a routine screening colonoscopy with the removal of a rectosigmoid polyp consistent with xanthoma and tubular adenoma histopathology. Proper follow-up for identification of possible metabolic derangements and increased colonic surveillance is recommended to mitigate the risk of further xanthoma or adenocarcinoma formation.