-Case Reports-

A Case of an Inflammatory Fibroid Polyp of the Cecum

Hayato Kan¹, Hideyuki Suzuki¹, Seiichi Shinji^1,2, Zenya Naito³, Kiyonori Furukawa² and Takashi Tajiri¹

¹Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
²Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital
³Department of Pathology, Nippon Medical School

An inflammatory fibroid polyp (IFP) is a rare benign lesion, originating in the submucosa of the gastrointestinal tract. It is histopathologically characterized by distinctively arranged fibrous connective tissue and blood vessels with inflammatory cell infiltration. It typically arises in the stomach and small intestine but also arises infrequently in the colon. This report describes a case of IFP of the cecum. A 63-year-old woman presented with persistent bloody stool for more than 1 month. Colonoscopy revealed a polypoid lesion, measuring 2.5 cm in diameter and 4 cm in length, with a thick pedicle in the cecum. Histopathological examination of the biopsy specimen showed hyperplastic changes of the mucosa. The lesion was diagnosed to be a submucosal tumor. We concluded that endoscopic mucosal resection would be difficult because the polyp showed signs of infiltration into the submucosa. Furthermore, the possibility of malignancy could not be ruled out. Laparoscopy-assisted ileocecal resection with lymphnode dissection was performed after the patient's informed consent was obtained. The lesion was finally diagnosed to be IFP on the basis of histopathological examination of the resected specimen. Immunohistochemical staining of the spindle-shaped cells, which were present around the small vessels in the stroma of the tumor, showed that the tissue expressed vimentin but not α-smooth muscle actin, desmin, S-100, c-kit or CD 34. IFP is difficult to diagnose without the recognition of its clinical and pathological characteristics. It is also important to determinate the depth of the lesion before selecting the therapeutic method.

J Nippon Med Sch 2008; 75: 181-186

Keywords
inflammatory fibroid polyp, submucosal tumor of the colon, laparoscopy-assisted surgery, immunohistochemical staining

Correspondence to
Hayato Kan, Division of Gastroenterology, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo 113-8603, Japan
hkan@nms.ac.jp

Received, December 19, 2007
Accepted, March 6, 2008