1
|
Lu Y, Huang L, Lou X, Chen C, Sun J. Clinical, endoscopic, pathological characteristics and management of cap polyposis: experience from a Tertiary Hospital in China. Front Pharmacol 2024; 15:1391367. [PMID: 38783946 PMCID: PMC11111883 DOI: 10.3389/fphar.2024.1391367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Background and aims Cap polyposis (CP) is a rare kind of benign disease, and the majority of previously published relevant articles involve a small number of patients. Hence, we summarized our experience to contribute additional data, hoping to raise awareness of this disease. Methods From 1 January 2017 to 1 November 2021, consecutive patients diagnosed with CP were retrospectively reviewed. Their medical histories, and laboratory, imaging, endoscopic, and pathology results were analyzed. We made telephone calls to the patients and searched for the information in our electronic medical records to obtain the follow-up results. Results Forty-one patients were chosen for analysis. The median age of the patients was 20 years old, and 90.24% (37 patients) of the patients were male. The majority of the patients presented with hematochezia. The rectum was the most commonly affected site, and the Helicobacter pylori infection rate was high. There were multiple and combined treatments for these patients. These treatments can be divided into 3 main categories: medical therapy, endotherapy and surgery. Medical therapy helped to diminish the size of but the polyps were difficult to resolve; however, the patients' symptoms could be diminished. Twenty-three patients underwent surgical resection, and 12 patients received endotherapy. We further compared the two methods of polyp resection. Both endotherapy and surgery were safe, and the recurrence risk was not significantly different between the two kinds of therapy (p = 0.321). Conclusion The clinical improvement of medical treatments was not satisfactory, and endotherapy or surgical resection could remove the polyposis and provide temporary relief, but the recurrence rates were high.
Collapse
Affiliation(s)
- Yi Lu
- Department of Gastrointestinal Endoscopy, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lingyu Huang
- Department of Gastrointestinal Endoscopy, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoying Lou
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Pathology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chunyu Chen
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiachen Sun
- Department of Gastrointestinal Endoscopy, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
2
|
Emami A, Shokri Shirvani J, Hosseini A, Hamidi SH. Solitary rectal ulcer transformation to cap polyposis in a 15-year-old child. BMC Gastroenterol 2022; 22:104. [PMID: 35255826 PMCID: PMC8900421 DOI: 10.1186/s12876-022-02122-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cap polyposis (CP) is a benign, non-malignant inflammatory disease that affects the rectum. It usually occurs during the 5th decade of life, but children could also be affected. Its specific pathology is unknown. Due to the clinical, endoscopic, and histologic similarities with other disorders such as inflammatory bowel disease, a thorough histologic evaluation is critical to avoid unnecessary interventions. This study presents a 15-year-old child with a previously reported case of solitary rectal ulcer (SRU) that developed into CP determined by colonoscopy and histologic findings. CASE PRESENTATION A 15-year-old boy who was previously diagnosed with SRU presented to our office with rectal bleeding, mucoid discharge, and abdominal pain. Additional colonoscopy evaluation revealed multiple polyposes varying in size and shape limited to the rectum. Histologic examination revealed a characteristic cap of granulation tissue covering tortuous nondysplastic crypts in the inflamed stroma, indicating that SRU had transformed into CP. Based on the assessments, we planned to perform endoscopic mucosal resection of the lesions in multiple sessions. CONCLUSIONS Despite the rarity of CP, the transformation from SRU may be one of its etiologies. Thus, thorough serial histologic evaluation is critical in children with rectal bleeding to avoid unnecessary or harmful interventions.
Collapse
Affiliation(s)
- Abdolreza Emami
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Javad Shokri Shirvani
- Department of Internal Medicine, School of Medicine, Babol University of Medical Sciences, GanjAfrooz Street, 47176-47745, Babol, Mazandaran, Islamic Republic of Iran.
| | - Akramasadat Hosseini
- Department of Pathology, School of Medicine, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Seyed Hossein Hamidi
- Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| |
Collapse
|
3
|
Liu C, Gong B, Lv C, Xue S. A rare case of cap polyposis. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 113:675-676. [PMID: 34015934 DOI: 10.17235/reed.2021.8043/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The patient was a 63-year-old male with mucus and bloody stool more than 20 times a day mixed with a lot of pseudomembrane. The symptoms lasted over three months. Thus, he underwent a colonoscopy in another hospital at disease onset, the polyp was found and resected during the procedure. The symptoms were reduced but recurred two weeks later. A recent colonoscopy showed a large number of erythematous inflammatory colonic polyps covered by fibrous purulent mucus. The polyps were sessile and erosive, dark red, accompanied by fibrous, purulent and mucous-like secretions, similar to those reported by Monsalve Alonso S et al.
Collapse
Affiliation(s)
- Chang Liu
- Gastroenterology, Shuguang Hospital. Shanghai University of Traditional Chinese Medicine
| | - Biao Gong
- Gastroenterology, Shuguang Hospital. Shanghai University of Traditional Chinese Medicine
| | - Chan Lv
- Gastroenterology, Shuguang Hospital. Shanghai University of Traditional Chinese Medicine
| | - Shigui Xue
- Digestive Endoscopy Center, Shuguang Hospital. Shanghai University of Traditional Chinese Medicine, China
| |
Collapse
|