A solitary rectal juvenile polyp with chicken skin‑like changes in the surrounding mucosa in an adult: A case report

Abstract

The majority of colorectal polyps in adults are adenomatous polyps, while hamartoma polyps are rare. Juvenile polyps are the most common type of polyp in children; however, they are rare in adults. Fecal calprotectin (FCP) is commonly elevated in inflammatory bowel disease and is rarely studied in juvenile rectal polyps. Reports of elevated FCP in solitary juvenile rectal polyps of adults are rare. A 57-year-old female was admitted to The Affiliated Hospital of Qingdao University (Qingdao, China) for treatment due to intermittent stool with mucus and blood. Colonoscopy revealed a solitary polyp in the rectum with a diameter of ~2.0 cm, a short and wide subpedicle, with congested and swollen mucosa on the surface and chicken skin-like changes in the surrounding mucosa. The patient had no family history of colorectal polyps or cancer. Endoscopic submucosal dissection was used to remove the polyp. Histopathological examination indicated that the polyp was a juvenile polyp and no signs of malignancy were found. The present case report describes details on this case of an adult patient with a solitary juvenile rectal polyp with chicken skin-like changes in the surrounding mucosa and high FCP.

Mucosa color and size may indicate malignant transformation of chicken skin mucosa-positive colorectal neoplastic polyps

“…CSM-positive colorectal polyps are frequently found during routine screening colonoscopies, with a prevalence ranging from 29.5% to 31.3%[ 2 , 4 , 10 ]. According to the related literature[ 2 - 5 , 7 , 10 , 11 ], CSM is involved in a wide range of diseases, including juvenile polyps, neoplastic polyps, advanced colorectal adenoma, submucosal invasion, colorectal cancer, and de novo colorectal cancer. Endoscopists usually make treatment choices based on the endoscopic features of the lesion[ 13 ].…”

“…Endoscopic submucosal dissection (ESD) can be used to resect sessile or flat adenomatous lesions, as well as complete resection of large (> 2 cm) colonic lesions and early submucosal invasive carcinoma (within the SM1), which is unrivaled by other techniques[ 19 ]. Surgical resection is recommended for the treatment of difficult-to-resect lesions and neoplastic polyps associated with deep mucosa carcinoma (the penetration depth of carcinoma to the inferior margin of mucous muscle is beyond 1000 μm)[ 7 ].…”

“…CSM was first reported in 1998 by Shatz et al [ 6 ]. Subsequently, several studies have shown that CSM is associated with juvenile polyps in both adults and children[ 5 , 7 ]. As the expression of Ki-67 or p53 in the CSM around juvenile polyps does not increase, they are not believed to be preneoplastic[ 8 , 9 ].…”