Giant Inflammatory Fibroid Polyp of the Descending Colon Treated with Endoscopic Resection

Abstract

Inflammatory fibroid polyps (IFPs) of the colon are very rare, reactive, non-neoplastic polyps that may grow to large sizes but do not carry any risk of malignancy. Because of their size, IFPs are usually treated with surgery; however, size alone should not be an indication for surgery. Depending on the location and morphology of the polyp, endoscopic resection should be considered. We here describe a case of a giant IFP that was successfully removed with endoscopy without complication or recurrence.

Figure 1

(A) CT scan showing large hypodense hetereogenous mass measuring 5 cm (arrow), occupying most of the descending colon. (B) Endoscopic view of the large colonic mass obstructing the lumen of the descending colon. (C) Endoscopic view of the post polypectomy site (endoloop and endoclips seen at the site). (D) Gross view of the colonic mass after endoscopic resection.

Figure 2

(A) Intermediate power view of the inflammatory fibroid polyp showing the rich vascular supply (arrows) highlighted by a CD34 immunostain. Tissue section. CD 34 immunostain. Original magnification ×100. (B) Eosinophils within the stroma. Inflammatory fibroid polyp. Tissue section, hematoxylin, and eosin; original magnification ×1,000.

Figure 3

(A) Low power view. Submucosal stromal proliferation with superimposed hemorrhage. Inflammatory fibroid polyp, tissue section. Hematoxylin and eosin, original magnification ×20. (B) High power view of the inflammatory fibroid polyp displaying a rich vascularized area with branching capillaries surrounded by a collagenous stroma containing bland spindle cells. Tissue section. Hematoxylin and eosin, original magnification ×200. (C) Low power view of the deep aspect of the inflammatory fibroid polyp displaying rich vascularized areas. Tissue section. Hematoxylin and eosin, original magnification ×40.