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- W2978477410 abstract "Filiform polyposis (FP), a rare non neoplastic condition of unknown pathogenesis is characterized by multiple slender, vermiform-like projections in the colon lined by normal or inflammatory colonic mucosa. It can occur in 10-20% of inflammatory bowel disease and has also been reported in intestinal tuberculosis or histiocytosis X. In rare cases, several filiform polyps can form large tumor masses called giant filiform polyposis. Filiform polyposis is thought to occur due to repeated bouts of inflammation and ulceration along with the healing process. Only a few cases have been reported outside the setting of IBD. We report a case of Filiform polyposis in the setting of recurrent diverticulitis. A 58-year-old male with a history of recurrent diverticulitis was admitted with abdominal pain and worsening constipation. He denied any weight loss, rectal bleeding or family history of colon cancer. No prior history of inflammatory bowel disease. A CT of the abdomen and pelvis with IV contrast showed the possibility of a sigmoid mass concerning for a malignancy. Subsequent colonoscopy to investigate showed numerous vermiform like projections in the sigmoid colon along with a polypoid-like mass. Multiple biopsies showed no adenomatous changes or malignancy. Given the appearance and concern for malignancy a repeat colonoscopy was carried out to obtain additional biopsies. Repeat biopsies again showed no malignancy but features consistent with filiform polyposis. Although this condition is a benign entity and does not seem to have a high risk of malignant transformation, cases have been reported where adenomas have developed over years and Boulagnon et al reported a case of adenocarcinoma developing in the setting of filiform polyposis; hence periodic follow up seems necessary. Unfortunately, there are no specific guidelines on the duration of follow up with these patients. Chang Geun Lee et al reported a case series of seven patients and followed those patients up to 46 months after diagnosis. This case series reported no malignancy. It is generally felt that these lesions can be left alone without any surgical intervention unless complications like obstruction or hemorrhage ensues which may need surgical excision. This case demonstrates the importance of gastroenterologists being aware of this rare entity and its endoscopic appearance so a proper management plan can be implemented. More data is needed in regards to follow up and surveillance.Figure 1Figure 2Figure 3" @default.
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- W2978477410 date "2016-10-01" @default.
- W2978477410 modified "2023-09-27" @default.
- W2978477410 title "Filiform Polyposis: Is This Malignancy Doc?" @default.
- W2978477410 doi "https://doi.org/10.14309/00000434-201610001-01403" @default.
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