A Case of Solitary Peutz Jeghers Type Polyp of the Ileum

Abstract

A 2-year-old girl presented with anemia and a positive fecal occult blood test. There was no significant family history. Abdominal CT showed a round intramural mass in the terminal ileum. Cutaneous pigmentation was not found on her lips or the fingers of either hand. Contrast study of the small intestine revealed a solitary pedunculated polyp in the ileum. With a diagnosis of small intestinal polyp, we resected 6cm of the ileum including the polyp followed by a modified functional end-to-end anastomosis. Histopathological examination showed typical features of a Peutz-Jeghers type (hamartomatous) polyp without atypia. A solitary Peutz-Jeghers type polyp occurring in the absence of Peutz-Jeghers syndrome in children is rare, and only 6 cases including our case have been reported in Japan to the best of our knowledge. We suggest that one should consider a Peutz-Jeghers type polyp as a differential diagnosis for patients with anemia and a positive fecal occult blood test, because of its potential malignancy and potential cause of extensive intestinal necrosis.