Steroid therapy for Cronkhite-Canada syndrome reduced inflammation, leading to difficulty in detection of accompanying small adenomas in colon

Abstract

A 74-year-old man admitted to our hospital with diarrhea and alopecia. Gastroendoscopy and colonoscopy revealed diffuse reddish, inflammatory polyps and adjacent edematous mucosa in the stomach and colon. Histopathology of biopsy specimens showed cystic dilatation of mucosal glands and invasion by inflammatory cells, compatible with Cronkhite-Canada syndrome. Narrow band imaging identified eleven polyps in the colon showing NBI International Colorectal Endoscopic (NICE) Classification type 2, and histopathology of biopsy specimens from the polyps showed several adenoma cells. He was treated intravenously with prednisolone (PSL) at 50 mg/day, and his symptoms improved. PSL was gradually tapered and was continued orally at 10 mg/day. Six months after initiating steroid therapy, repeat colonoscopy revealed resolution of inflammatory polyposis and could not detect NICE Classification type 2 polyps.