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Should you trust the radiologist?

INTRODUCTION A colonoscopy was performed in a 65yearold asymptomatic patient with a positive faecal immunochemical test. Their only medical history was wellcontrolled asthma. The colonoscopy was performed by an experienced bowel cancer screening endoscopist. The examination found a lumenfilling lesion in the ascending colon (figure 1) just downstream to the ileocaecal valve. The lesion was hard to touch and biopsies were taken. The appearance was compatible with an eroding submucosal lesion. The endoscopist informed the patient of the likely diagnosis of cancer, and requested urgent imaging. The case was discussed in the Complex Polyp and Colorectal Cancer Meeting. Opinions were sought from senior endoscopists and surgeons. The unanimous opinion was that the endoscopic images were concerning for cancer, a gastrointestinal stromal tumour or metastasis. The biopsies were nondiagnostic. A CT scan of the abdomen and pelvis demonstrated a 4.5 cm welldefined rounded homogenous fat attenuating lesion, completely