Cap Polyposis from Mucosal Prolapse Syndrome Observed Over a 10-year Follow-up Period, Report of a Case Hiroshi Nakano 1 , Mitsuo Nagasaka 1 , Masato Kamiya 1 1Department of Internal Medicine, School of Medicine, Fujita Health University Keyword: 粘膜脱症候群 , cap polyposis pp.741-749
Published Date 2002/4/25
DOI https://doi.org/10.11477/mf.1403103520
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 A 64-year-old woman presented, in June 1990, with persistent mucous diarrhea and lower abdominal pain. Barium enema revealed an area of stenosis in the upper part of the rectum and the next rectosigmoid colon was spastic. Colonoscopy showed shallow ulcers on the transverse mucosal folds in the rectum and the prolapsing of the inner mucosa from the stenotic, fixed point. Mucosal prolapse syndrome (MPS) in the sigmoid colon due to adherent ovaries was diagnosed and, because of intractable symptoms, low anterior rectosigmoid-resection was performed on June 13,1991. The resected specimen showed hypertrophic transverse mucosal folds with flat polypoid lesions. The polypoid lesions were composed of elongated glands with fibromusculosis, inflammatory cells infiltration and the submucosal layer was elevated with rich vascular components. MPS was the pathological diagnosis.

 Unfortunately the patient's symptoms recurred within a short time and resection of the anastomosis and colostomy in the descending colon was carried out. However, the symptoms with mucous discharge in the remnant rectum and the pain in the upper abdomen persisted for a long time.

 About 10 years after the first operation, barium enema, in November 1999, showed many polypoid lesions on the apices of the transverse mucosal folds and their surface was covered by ‘cap’ with whitish mucous exudates. Polypectomy specimens showed findings comparable to cap polyps.

 The condition of this patient was diagnosed as a cap polyposis (CP).

 In this case, the course of MPS to CP was observed and the etiological factors of both clinical entites were thought to be similar and connected.

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