Endoscopy 2002; 34(6): 499-502
DOI: 10.1055/s-2002-32008
Case Report
© Georg Thieme Verlag Stuttgart · New York

A Case of Hyperplastic Polyposis of the Colon with Adenocarcinomas in Hyperplastic Polyps after Long-Term Follow-Up

N.  Koide 1 , Y.  Saito 1 , T.  Fujii 1 , H.  Kondo 1 , D.  Saito 1 , T.  Shimoda 2
  • 1Deptartment of Endoscopy, National Cancer Center Hospital, Tokyo, Japan
  • 2Clinical Laboratory Department, National Cancer Center Hospital, Tokyo, Japan
Further Information

Publication History

30 August 2001

19 December 2001

Publication Date:
04 June 2002 (online)

A 66-year-old woman had been receiving follow-up since 1990 for hyperplastic polyposis, which remained unchanged endoscopically and radiologically. In 1999, a small (28 × 22 mm) superficial adenocarcinoma was detected in the ascending colon. Histologically, this was a hyperplastic polyp containing a well-differentiated adenocarcinoma invading into the submucosa. A review of the English and Japanese literature identified 32 cases of “hyperplastic polyposis.” In about half of the 32 cases, an adenocarcinoma was also found amongst the hyperplastic polyps. Half of the adenocarcinomas were located in the right colon. Although hyperplastic polyposis is uncommon, it warrants regular surveillance, as it appears to be associated with an increased risk of colorectal cancer.

References

  • 1 Goldman H, Ming S, Hickok D F. Nature and significance of hyperplastic polyps of the human colon.  Arch Pathol. 1970;  89 349-354
  • 2 Church J M, Fazio V W, Jones I T. Small colorectal polyps: Are they worth treating?.  Dis Colon Rectum. 1988;  31 50-53
  • 3 Williams G T, Arthur J F, Bussey H JR. et al . Metaplastic polyps and polyposis of the colorectum.  Histopathology. 1980;  4 155-170
  • 4 McCann B G. A case of metaplastic polyposis of the colon associated with focal adenomatous change and metachronous adenocarcinomas.  Histopathology. 1988;  13 700-702
  • 5 Orii S, Nakamura S, Sugai T. et al . Hyperplastic (metaplastic) polyposis of the colorectum associated with adenomas and an adenocarcinoma.  J Clin Gastroenterol. 1997;  25 369-372
  • 6 Cooke S AR. Polyposis coli: The clinical spectrum in adults.  S Afr Med J. 1978;  53 454-457
  • 7 Sumner H W, Wasserman N F, McClain C J. Giant hyperplastic polyposis of the colon.  Dig Dis Sci. 1981;  26 85-89
  • 8 Cohen S M, Brown L, Janower M L. et al . Multiple metaplastic (hyperplastic) polyposis of the colon.  Gastrointest Radiol. 1981;  6 333-335
  • 9 Bengoechea O, Martinez-Penuela J M, Larrinaga B. et al . Hyperplastic polyposis of colorectum and adenocarcinoma in a 24-year-old-man.  Am J Surg Pathol. 1987;  11 323-327
  • 10 Kusunoki M, Fujita S, Sakanoue Y. et al . Disappearance of hyperplastic polyposis after resection of rectal cancer: Report of two cases.  Dis Colon Rectum. 1991;  34 829-832
  • 11 Warner A S, Glick M E, Fogt F. Multiple large hyperplastic polyps of the colon coincident with adenocarcinoma.  Am J Gastroenterol. 1994;  89 123-125
  • 12 Torlakovic E, Snover D C. Serrated adenomatous polyposis in humans.  Gastroenterology. 1996;  110 748-755
  • 13 Place R J, Simmang C L. Hyperplastic-adenomatous polyposis syndrome.  J Am Coll Surg. 1999;  188 503-507
  • 14 Cooper H S, Patchefsky A S, Marks G. Adenomatous and carcinomatous changes within hyperplastic colonic epithelium.  Dis Colon Rectum. 1979;  22 152-156
  • 15 Spjut H J, Estrada R G. The significance of epithelial polyps of the large bowel.  Pathol Annu. 1977;  12 147-170
  • 16 Teoh H H, Delahunt B, Isbister W H. Dysplastic and malignant areas in hyperplastic polyps of the large intestine.  Pathology. 1989;  21 138-142
  • 17 Tsuchida K, Kanamori T, Okumura F. et al . Multiple metaplastic polyps of the colorectum characterized by three metaplastic polyps containing an invasive carcinoma and two intramucosal carcinomas: a case report [in Japanese with English abstract].  Gastroenterol Endosc. 1995;  37 2460-2468
  • 18 Hayakawa K, Yamada N, Fukuchi S. et al . Metaplastic polyp, polyposis [in Japanese].  Nihon Rinsho. 1991;  49 2948-2954
  • 19 Yamagiwa H, Yoshimura H, Tomiyama H. et al . A case of metaplastic polyposis of the intestine with rectal cancer [in Japanese].  Gekachiryou. 1985;  52 236-239
  • 20 Yamada N, Fukuchi S, Ogawa T. et al . Multiple metaplastic polyps of the colon associated with adenomas complicating focal carcinoma: report of a case [in Japanese with English abstract].  Stomach Intest. 1983;  18 523-530
  • 21 Kudo S, Hirota S, Nakajima T. et al . Colorectal tumors and pit pattern.  J Clin Pathol. 1994;  47 880-885
  • 22 Arthur J F. Structure and significance of metaplastic nodules in the rectal mucosa.  J Clin Pathol. 1968;  21 735-743
  • 23 Franzin G, Zamboni G, Scarpa A. et al . Hyperplastic (metaplastic) polyps of the colon: A histologic and histochemical study.  Am J Surg Pathol. 1984;  8 687-698
  • 24 Kaye G I, Fenoglio C M, Pascal R R. et al . Comparative electron microscopic features of normal, hyperplastic, and adenomatous human colonic epithelium.  Gastroenterology. 1973;  64 926-945
  • 25 Boland C R, Montgomery C K, Kim Y S. A cancer-associated mucin alteration in benign colonic polyps.  Gastroenterology. 1982;  82 664-672
  • 26 Jass J R, Filipe M I, Abbas S. et al . A morphologic and histochemical study of metaplastic polyps of the colorectum.  Cancer. 1984;  53 510-515
  • 27 Skinner J M, Whitehead R. Tumor-associated antigens in polyps and carcinoma of the human large bowel.  Cancer. 1981;  47 1241-1245
  • 28 Bara J, Languille O, Gendron M C. et al . Immunohistochemical study of precancerous mucus modification in human distal colonic polyps.  Cancer Res. 1983;  43 3885-3891
  • 29 Czernobilsky B, Tsou K C. Adenocarcinoma, adenoma and polyps of the colon.  Cancer. 1968;  21 165-177
  • 30 Wattenberg L W. A histochemical study of five oxidative enzymes in carcinoma of the large intestine in man.  Am J Pathol. 1959;  35 113-126
  • 31 Jass J R. Relation between metaplastic polyp and carcinoma of the colorectum.  Lancet. 1983;  1 28-29
  • 32 Gebberts J O, Laissue J A. Mixed hyperplastic polyp and neoplastic polyp of the colon: An immunohistochemical study.  Virchows Arch A. 1986;  410 189-194
  • 33 Hawkins N J, Gorman P, Tomlinson I PM. et al . Colorectal carcinomas arising in the hyperplastic polyposis syndrome progress through the chromosomal instability pathway.  Am J Pathol. 2000;  157 385-392

N. Koide, M.D.

Dept. of Endoscopy · National Cancer Center Hospital

5-1-1 Tsukiji · Chuo-ku · Tokyo 104-0045 · Japan

Fax: + 81-3-3542-3815

Email: nkoide@ncc.go.jp

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