Cargando…

Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report

BACKGROUND: Juvenile polyps are the most common type of polyps in children but are rare in adults. Inflammatory bowel disease (IBD) patients have a similar spectrum of symptoms as patients with juvenile polyps. Both patients with juvenile polyps and those with active IBD have high fecal calprotectin...

Descripción completa

Detalles Bibliográficos
Autores principales: Chen, You-Wei, Tu, Jiang-Feng, Shen, Wen-Juan, Chen, Wan-Yuan, Dong, Jie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052536/
https://www.ncbi.nlm.nih.gov/pubmed/32148384
http://dx.doi.org/10.3748/wjg.v26.i8.877
_version_ 1783502896210378752
author Chen, You-Wei
Tu, Jiang-Feng
Shen, Wen-Juan
Chen, Wan-Yuan
Dong, Jie
author_facet Chen, You-Wei
Tu, Jiang-Feng
Shen, Wen-Juan
Chen, Wan-Yuan
Dong, Jie
author_sort Chen, You-Wei
collection PubMed
description BACKGROUND: Juvenile polyps are the most common type of polyps in children but are rare in adults. Inflammatory bowel disease (IBD) patients have a similar spectrum of symptoms as patients with juvenile polyps. Both patients with juvenile polyps and those with active IBD have high fecal calprotectin levels. Four cases of children with ulcerative colitis (UC) with solitary juvenile polyps and one case of an adult with UC with juvenile polyposis syndrome have been reported upon diagnosis of UC, while there have been no cases of adults with UC with solitary juvenile polyp reported in the literature. CASE SUMMARY: A 37-year-old man with a 12-year history of UC was admitted to our clinic because of increased stool frequency. UC was diagnosed at the age of 25. As the lesion was confined to the rectum, sulfasalazine suppositories or mesalazine suppositories were used. The patient was followed in an outpatient clinic, and colonoscopy was performed every one or two years. The latest examination was undertaken three years prior in the presence of proctitis. Recently, the patient complained of three to five bowel movements a day. There was mucus in the stool but no visible blood. Colonoscopy revealed a solitary polyp, about 1.5 cm in diameter, with a short and broad peduncle in the transverse colon surrounded by congestive and edematous mucosa. The patient had no family history of colorectal polyps or cancer. The polyp was successfully removed by endoscopic mucosal resection. Histopathological examination revealed that the polyp was a juvenile polyp without any malignant signs. Immunohistochemical staining for p53 showed wild-type expression and p53 overexpression was not detected. Ki-67 labeling index was 3%. CONCLUSION: This is the first case of an adult UC patient with a solitary juvenile polyp at the 12-year follow-up. The correlation between juvenile polyps and the activity of IBD needs further study.
format Online
Article
Text
id pubmed-7052536
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Baishideng Publishing Group Inc
record_format MEDLINE/PubMed
spelling pubmed-70525362020-03-06 Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report Chen, You-Wei Tu, Jiang-Feng Shen, Wen-Juan Chen, Wan-Yuan Dong, Jie World J Gastroenterol Case Report BACKGROUND: Juvenile polyps are the most common type of polyps in children but are rare in adults. Inflammatory bowel disease (IBD) patients have a similar spectrum of symptoms as patients with juvenile polyps. Both patients with juvenile polyps and those with active IBD have high fecal calprotectin levels. Four cases of children with ulcerative colitis (UC) with solitary juvenile polyps and one case of an adult with UC with juvenile polyposis syndrome have been reported upon diagnosis of UC, while there have been no cases of adults with UC with solitary juvenile polyp reported in the literature. CASE SUMMARY: A 37-year-old man with a 12-year history of UC was admitted to our clinic because of increased stool frequency. UC was diagnosed at the age of 25. As the lesion was confined to the rectum, sulfasalazine suppositories or mesalazine suppositories were used. The patient was followed in an outpatient clinic, and colonoscopy was performed every one or two years. The latest examination was undertaken three years prior in the presence of proctitis. Recently, the patient complained of three to five bowel movements a day. There was mucus in the stool but no visible blood. Colonoscopy revealed a solitary polyp, about 1.5 cm in diameter, with a short and broad peduncle in the transverse colon surrounded by congestive and edematous mucosa. The patient had no family history of colorectal polyps or cancer. The polyp was successfully removed by endoscopic mucosal resection. Histopathological examination revealed that the polyp was a juvenile polyp without any malignant signs. Immunohistochemical staining for p53 showed wild-type expression and p53 overexpression was not detected. Ki-67 labeling index was 3%. CONCLUSION: This is the first case of an adult UC patient with a solitary juvenile polyp at the 12-year follow-up. The correlation between juvenile polyps and the activity of IBD needs further study. Baishideng Publishing Group Inc 2020-02-28 2020-02-28 /pmc/articles/PMC7052536/ /pubmed/32148384 http://dx.doi.org/10.3748/wjg.v26.i8.877 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Chen, You-Wei
Tu, Jiang-Feng
Shen, Wen-Juan
Chen, Wan-Yuan
Dong, Jie
Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report
title Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report
title_full Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report
title_fullStr Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report
title_full_unstemmed Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report
title_short Diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: A case report
title_sort diagnosis and management of a solitary colorectal juvenile polyp in an adult during follow-up for ulcerative colitis: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052536/
https://www.ncbi.nlm.nih.gov/pubmed/32148384
http://dx.doi.org/10.3748/wjg.v26.i8.877
work_keys_str_mv AT chenyouwei diagnosisandmanagementofasolitarycolorectaljuvenilepolypinanadultduringfollowupforulcerativecolitisacasereport
AT tujiangfeng diagnosisandmanagementofasolitarycolorectaljuvenilepolypinanadultduringfollowupforulcerativecolitisacasereport
AT shenwenjuan diagnosisandmanagementofasolitarycolorectaljuvenilepolypinanadultduringfollowupforulcerativecolitisacasereport
AT chenwanyuan diagnosisandmanagementofasolitarycolorectaljuvenilepolypinanadultduringfollowupforulcerativecolitisacasereport
AT dongjie diagnosisandmanagementofasolitarycolorectaljuvenilepolypinanadultduringfollowupforulcerativecolitisacasereport