Ann Coloproctol.  2024 May;40(Suppl 1):S27-S31. 10.3393/ac.2022.00549.0078.

A case report of a giant solitary juvenile polyp: from obstructed defecation syndrome to incontinence

Affiliations
  • 1Department of Surgery, Hospital Universiti Sains Malaysia, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
  • 2Department of Radiology, Hospital Universiti Sains Malaysia, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
  • 3Department of Pathology, Hospital Universiti Sains Malaysia, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

Abstract

Juvenile polyps (JPs) are the most common polyps in pediatric patients. We present the case of an 18-year-old male patient with a giant solitary JP resembling solitary rectal ulcer syndrome (SRUS). The presenting history was rectal bleeding and symptoms of obstructed defecation syndrome. Colonoscopy revealed a polypoidal mass at the anorectal junction, with biopsy-confirmed SRUS. The symptoms worsened, and a protruding mass from the anus caused fecal incontinence. Pelvic magnetic resonance imaging showed a huge pedunculated mass occupying the low rectum with local compression of the urinary bladder. Transanal excision of the anal tumor was performed due to bleeding. A histopathological examination showed a JP with high-grade dysplasia. A histological examination to differentiate JPs and SRUS could be challenging based on a superficial forceps biopsy. Therefore, an excision biopsy is usually warranted with the understanding that adenomatous or malignant transformation is found in 5.6% to 12% of all JPs.

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