Korean J Gastroenterol.  2011 Nov;58(5):275-279. 10.4166/kjg.2011.58.5.275.

A Case of Cap Polyposis Complicated with Idiopathic Retroperitoneal Fibrosis

• Song L
• Jhun BW
• Park J
• Kim D
• Chang DK
• Kim YH
• Kim JJ
• Kim JY

• KMID: 1026370
• DOI: http://doi.org/10.4166/kjg.2011.58.5.275

Abstract

An optimal treatment for cap polyposis has not been established. Several treatment approaches, including anti-inflammatory agents, antibiotics, immunomodulators, and endoscopic therapy have been described. Surgical resection of the affected colon and rectum may be indicated for patients with persistent disease. Repeat surgery is indicated in cases of recurrence after surgery. However, symptomatic polyposis may still recur, and spontaneous resolution of cap polyposis is possible. We report a case of recurrent cap polyposis complicated with retroperitoneal fibrosis after inadequate low anterior resection with a positive resection margin. Surgical approaches for the treatment of cap polyposis should be carefully considered before treatment.

Keyword

Cap polyposis; Retroperitoneal fibrosis; Prednisolone; Low anterior resection

MeSH Terms

Anti-Inflammatory Agents/therapeutic use
Colonic Polyps/surgery
Colonoscopy
Female
Humans
Intestinal Polyposis/complications/*diagnosis/pathology
Middle Aged
Prednisolone/therapeutic use
Recurrence
Retroperitoneal Fibrosis/complications/*diagnosis/drug therapy
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Abdominopelvic CT finding. (A) It showed soft tissue infiltrations (arrow) surrounding the presacral space. (B) Associated hydronephroureterosis was noted.

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  Fig. 2. Colonoscopic image. Sessile polyps with caps of purulent exudates were observed.

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  Fig. 3. Pathologic finding of colonoscopic biopy. It showed the surface of polyps covered by exudates (H&E, ×100).

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  Fig. 4. Pathologic findings of retroperitoneal biopsy. (A) It showed fibroblast and lymphocyte infiltration in fibrosis (H&E, ×100). (B) Numerous blood vessels and peripheral nerves were observed due to secondary post- inflammatory change (H&E, ×100).

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  Fig. 5. Follow-up endoscopic images. It showed resolved cap polyposis.

Reference

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