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
1  Tropical Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Shaimaa Elkholy
2  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]).

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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.

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

Video 1 Endoscopic mucosal resection of rectal squamous cell papilloma.

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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.


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