Endosonographic Findings in Colitis Cystica Profunda

MRI Appearances Of Colitis Cystica Profunda: A Rare Benign Mimicker Of Colorectal Malignancy

“…Features of CCP can overlap with carcinoid tumour, mucinous adenocarcinoma, pancreatic heterotopia or adenomatous polyps of the anorectal region (inverted/pseudo-invasion). 3,4,9 Patients may present with a variety of symptoms, the most common being constipation, bleeding per rectum, mucus discharge, and abdomen pain. 5 Colonoscopy shows polypoidal/sessile lesions enclosed within normal, edematous or inflamed mucosa and/or ulcerations.…”

“…5 Colonoscopy shows polypoidal/sessile lesions enclosed within normal, edematous or inflamed mucosa and/or ulcerations. 4 Barium enema exhibits nodularity of the mucosa, polypoidal lesions, rectal stricture/ulceration, with thickened rectal folds; all of which are inconclusive findings. 6 Endoscopic anorectal ultrasound can be diagnostic by showing hypoechoic signal in the submucosal layer without adjacent deeper or muscular layer involvement, which clearly differentiates benign from malignant disease process.…”

“…5 Laxatives and dietary modification may improve symptoms of some patients, while others may require a surgical intervention. 4,5 Establishing the correct diagnosis for CCP is indispensable to avoid misdiagnosis accompanying extensive resection and oncologic attitude for a benign lesion that could be treated with appropriate measures, essentially maintaining the patient's quality of life. 9…”

“…CCP usually presents with nonspecific symptoms of mucorrhea, abdominal pain, rectal bleeding, tenesmus, and constipation; frequently misdiagnosed or confused with a malignancy, sometimes resulting in unnecessary interventions, be it surgical or pharmacological. 3,4 Our case illustrates the difficult diagnosis of this uncommon but problematic phenomenon, awareness of which is paramount for the concerning radiologists and clinicians. 5,6…”

“…1,2 Stark first described it in the colon of two autopsied cases of chronic dysentery and Vinchow was the one to name it 'colitis cystica polyposa'. [2][3][4][5][6] Rectum and the sigmoid colon are the commonest sites of affliction, but wide colonic distribution is also seen. 2 CCP has similar histological features as solitary rectal ulcer syndrome (SRUS) and the overlap between these conditions is not fully elucidated.…”