Filiform polyposis of the colon in chronic inflammatory bowel disease (so-called giant inflammatory polyps).
On the basis of 3 of our own cases, we describe unusually intense forms of filiform polyposis and local giant polyposis as a consequence of chronic inflammatory bowel disease. The patients are: A 52-year-old woman who for 7 years has been known to have Crohn's disease (CD); a 55-year-old man who for 14 years has been known to have chronic inflammatory bowel disease, which was first thought to have been ulcerative colitis, but, as a result of the findings on the subtotal colectomy specimen, had to be classified as Crohn's disease or colitis indeterminate; and a 53-year-old woman known to have had ulcerative colitis for 37 years. From the literature on the subject, we drew up a chronological list of a total of 43 cases with similar or completely identical findings. The clinical significance of the findings in their particularly massive intensity results from their necessary differentiation--in the context of differential diagnosis--from a malignant tumor, in particular from a carcinoma in association with chronic inflammatory bowel disease, or from a villous adenoma. The indication of a need to operate results from the impossibility of being able definitely to rule out a malignant degeneration by means of clinical methods. Also, experience shows that with massive findings of the kind described a spontaneous disappearance cannot be expected. Finally, too, the clinical symptoms and the patients subjective complaints necessitate balanced surgical treatment, taking into consideration the site and the extent of the lesion.
Bauknecht
K J
KJ
Department of General, Vascular, and Thorax Surgery, Auguste-Viktoria-Hospital, Berlin-Schöneberg.
Grosse
G
G
Kleinert
J
J
Lachmann
A
A
Niedobitek
F
F
D003082:Colectomy; D003106:Colon / Q000473:pathology; D003111:Colonic Polyps / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors