Asymptomatic cap polyposis from the sigmoid colon to the cecum

Abstract

“Cap polyposis,” first described by Williams et al. 1 Willams GT Bussey HJR Morson BC. Inflammatory ‘cap’ polyps of the large intestine. Br J Surg. 1985; 72 ([abstract]): S133 Google Scholar in 1985, is a rare condition with distinctive clinicopathologic features. This disease commonly affects the rectosigmoid colon, and the most common symptom is diarrhea. The pathogenesis is unknown but it has been postulated that abnormal colonic motility leading to mucosal prolapse may be an important etiologic factor. The typical endoscopic finding is multiple reddened sessile polyps located at the apices of transverse mucosal folds with normal intervening mucosa. Microscopically, the polyps consist of elongated tortuous crypts with a “cap” of fibrinopurulent exudate and inflammatory granulation tissue. This is a description of a case of cap polyposis in which the polyps were present from the sigmoid colon to cecum but produced no symptoms; further, polyps decreased in number over 4 months without any treatment. This is the first reported case of extensive cap polyposis in an asymptomatic patient.