Endoscopy 2018; 50(04): E83-E85
DOI: 10.1055/s-0043-123819
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic mucosal resection of rectal squamous cell papilloma

Mohamed Nabil Alkady
Tropical Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Shaimaa Elkholy
Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
› Author Affiliations
Further Information

Publication History

Publication Date:
19 January 2018 (eFirst)

A 22-year-old male patient presented with a 3-month history of persistent, colicky, lower abdominal pain. He was referred for colonoscopy. Total colonoscopy showed multiple small-to-medium sized pale pink, nonulcerated, polypoid lesions in the distal part of the rectum, occupying most of the circumference ([Fig. 1]).

Zoom Image
Fig. 1 Endoscopic view of squamous cell papilloma of the rectum using white light (a,c,d) and narrow-band imaging (b,e).

The patient’s medical history was not significant. After discussing his sexual history, he mentioned having a male partner for 2 years. Basic investigations were carried out, including human immunodeficiency virus serology; they were all negative. After discussing the treatment options with the patient, endoscopic mucosal resection of the lesions was performed ([Fig. 2], [Video 1]). Histopathological examination showed squamous cell papillomatosis of the rectum, with mild-to-moderate atypia ([Fig. 3]). Isolation of the human papilloma virus (HPV) from the specimen was not possible.

Zoom Image
Fig. 2 Complete endoscopic mucosal resection of squamous cell papilloma.

Video 1 Endoscopic mucosal resection of rectal squamous cell papilloma.

Georg Thieme Verlag. Please enable Java Script to watch the video.
Zoom Image
Fig. 3 Histopathological examination. a, b Hyperplastic stratified squamous epithelium with keratosis, vascular cores (a, arrow), and epitheliosis (b, arrow). c Squamous cell papilloma (SCP) with mild atypia (arrow). d SCP with focal moderate atypia (arrow).

Squamous cell papilloma (SCP) is a benign lesion that is a result of infection with HPV [1]. HPV-associated diseases are sexually transmitted and mainly affect the genitals, causing wart formation [2]. SCP arises from the stratified squamous epithelium of the skin, lip, oral cavity, tongue, pharynx, larynx, esophagus, cervix, vagina or anal canal [3]. SCP of the gastrointestinal tract is mainly localized to the oropharynx, esophagus, and anal canal [4]. The current case was an extremely rare case of rectal SCP.


Endoscopy E-Videos is a free access online section, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high quality video and all contributions are freely accessible online.
This section has its own submission website at https://mc.manuscriptcentral.com/e-videos