A 62-year-old female with a history of uncontrolled hypertension, diabetes, and chronic kidney disease was seen at an outpatient facility for screening colonoscopy. On review of systems, she denied abdominal pain, nausea or vomiting, change in bowel habits, or weight changes. She mentioned a family history of colorectal cancer in her paternal grandmother, though we do not have the age at diagnosis. During the initial colonoscopy, a 10-mm pedunculated ascending colon adenomatous polyp was identified and removed by a hot snare. Moreover, there was also a depressed 20-mm lesion in the ascending colon that was not removed or biopsied in order to avoid inducing fibrosis. The patient was referred to Stanford for endoscopic treatment.

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