Giant Inflammatory Fibroid Polyp of the Hepatic Flexure of Colon Presenting with an Acute Abdomen

Abstract

Background. Inflammatory Fibroid Polyp (IFP) of the colon is an exceedingly rare condition. Since 1952 till now only 32 cases have been reported worldwide of which only 5 were giant (>4 cm) polyps mostly found in the caecum (15 cases) with only 3 in the descending colon. Case Presentation. A 36-year-old female with no previous illness presented to the emergency unit with an acute onset pain over the right hypochondrium for 3 days associated with intermittent fever and anorexia. As she had evidence of localized peritonitis she underwent a diagnostic laparoscopy and subsequently an exploratory laparotomy. A mass measuring 8 × 7 × 5 cm arising from the hepatic flexure of colon was noted. Right hemicolectomy with ileotransverse anastomosis was performed. The mass was subsequently reported to be IFP. Conclusion. IFP is a very rare condition with clinical presentation depending upon its size and location. Definitive diagnosis is possible with histopathological examination of tissue aided by immunohistochemical studies. Surgical resection has been the most common method of treatment especially for large and giant colonic IFPs owing to challenges in terms of diagnosis and technical difficulties associated with endoscopic methods.

Inflammatory Fibroid Polyp Which is Presented with Invagination: Case Report

“…Although it is usually localized in the gastric antrum, it is less frequently seen in the small intestine, colon and esophagus as in the case presented. Although familial clustering of IFPs has been reported, its etiology is largely unknown (4).…”

Two Cases of Leiomyoma in the Colon Masquerading as Other Types of Colonic Pedunculated Polyps

“…The inflammatory fibroid polyp is a rare mesenchymal gastrointestinal tumor found mostly in the stomach (70%) and the small intestine (20%) [ 11 ]. Involvement of the colon in this disease is infrequent.…”

Inflammatory fibroid polyps of the appendix: different presentation and literature review

“…IFPs are rare, benign, idiopathic, pseudotumor, sub-mucosal neoplastic lesions originating in the GIT [ 3 ]. It was first described in the stomach by Vanek in 1949 as sub-mucosal granuloma with eosinophilic infiltration [ 2 ].…”

“…IFPs can be found anywhere in the GIT but most frequently in the stomach (70%), particularly in the antrum, followed by small intestines (20%), esophagus (2%), colorectal (5%) and appendix (<1%) [ 3 , 4 , 8 , 9 ]. When found in the appendix, the size ranges from 2 to 8 cm [ 5 , 10 ].…”

“…It was first discovered in the stomach by Vanek in 1949 as sub-mucosal granuloma with eosinophilic infiltration [ 2 ]. Their pathogenesis and etiology is not fully understood [ 3 ].…”