Giant inflammatory polyposis of the descending colon associated with a Crohn’s disease‐like colitis

Abstract

A case of giant inflammatory polyposis associated with a localized inflammatory bowel disease of the descending colon in a 49-year-old man is presented. Lower abdominal distension rapidly appeared without any previous history of gastrointestinal disease. Two months later, he underwent a left hemicolectomy. Postoperative recovery was complete and he remains in good health more than 2 years later. The resected colon showed a giant and bizarre polyposis measuring up to 12 cm in length and 2 cm in height and covering the entire circumference of the colon. The polyposis consisted of narrow worm- or noodle-like polyps that bridged over the irregularly shaped ulcers, which sometimes extended into muscularis propria. Although longitudinal ulcers or scars, stricture, and a cobble-stone appearance were not observed, transmural inflammation and deep fissures were found in the interpolypoid area. From these findings, this case seems to be more similar to Crohn's disease than other inflammatory bowel diseases.

Tumor-Like Growth of Giant Inflammatory Polyposis in a Patient with Ulcerative Colitis

“…Inflammatory polyps may originate from the regenerative mucosa in the remission stage after an acute recurrence of UC or CD. In rare cases, numerous large-sized polyps are present, and this condition is known as giant inflammatory (filiform) polyposis [8, 9, 10, 11, 12]. These polyps are associated with CD in approximately two-thirds of cases and with UC in one-third of cases.…”

“…On colonoscopy and radiologic studies, numerous filiform polyps appear as a ‘mass of worms’ or as a ‘fungating mass’; hence, this condition is easily confused with cancer. Inflammatory polyps or pseudopolyps are the most common lesions observed both in ulcerative colitis (UC) and Crohn's disease (CD) [8, 9, 10, 11, 12]. Moreover, in some cases, the polyps contain both mucosal and submucosal tissue, indicating initial inflammatory involvement of the deeper bowel layers.…”

Rectal localized giant inflammatory polyposis with indeterminate colitis

“…Another 7 cases were reported thereafter [3][4][5][6][7][8]. Of these 82 cases, 45 were associated with UC, 35 were associated with CD, and only 2 were not associated with IBD.…”

Rapid tumour‐like growth of giant filiform polyposis in a patient without a history of chronic bowel inflammation

“…A few giant filiform polyps have been reported in the literature (6–15), nearly all of them developing in patients with pre‐existing IBD, either of UC or CD subtype. Two of the cases presented as an obstructing tumour mass (12, 15).…”