A Surgical Case of Filiform Polyposis due to Ascending Colon Diverticulitis

Abstract

A 48-year-old woman underwent a contrast enema at another hospital with the chief complaint of right lower abdominal pain, and she was referred to our hospital with suspected ascending colon cancer with stenosis at the hepatic flexure. Computed tomography showed strong inflammation around the large mass, and blood tests also showed an increased inflammatory response and a mild increase in carcinoembryonic antigen (CEA). Because the stenosis was severe, immediate resection without colonoscopy was chosen and right hemicolectomy was performed through laparotomy. Intraoperative findings suggested advanced ascending colon cancer, with the formation of a small abscess and extensive inflammatory changes in the surrounding area, but the gross findings of the resected specimen showed that the mass was primarily located in and outside the intestinal wall. Numerous long villous protuberances were observed on the mucosal surface. Pathological examination showed no tumor component in the mass, and it was thought to be an inflammatory mass due to diverticulitis. The protuberance of the mucosal epithelium was only hyperplastic, and the diagnosis was filiform polyposis.

Filiform polyposis is a rare condition associated with chronic inflammation, and it is mainly associated with inflammatory bowel disease, but even more rarely with diverticulitis.