ABSTRACT
BACKGROUND/AIMS: Solitary rectal ulcer syndrome (SRUS) is a rare disorder that has a wide spectrum of clinical presentation and variable endoscopic findings. To further characterize the clinical and pathological features, a retrospective, hospital-based clinicopathological study was conducted. MATERIALS AND METHODS: All cases of SRUS diagnosed at Farwania Hospital, Kuwait, between 2002 and 2007 were retrieved from the computerized filing system. The histological slides were reviewed by two authors to confirm the diagnosis. Immunohistochemical stain for smooth muscle actin (SMA) was performed. The clinical files were reviewed for clinical features and endoscopic findings. RESULTS: Thirteen cases were identified: 8 males and 5 females. The age range was 15-85. Rectal bleeding, constipation, and abdominal pain were the most common presenting symptoms and were seen, either alone or in various combinations, in 12 of the 13 cases. Rectal ulceration was the most common endoscopic finding, being seen in 9 of the 3 cases; 3 of these cases had multiple ulcerations. Two patients had rectal polyps, with one of them having multiple polyps. The histological examination revealed surface serration, fibromuscular obliteration of the lamina propria, and crypts' distortion in all the cases. Seven of the cases had diamond crypts. Ectatic mucosal vessels were a common finding. Positivity for SMA in the lamina propria was seen in all examined cases. CONCLUSION: SRUS is a rare disorder and only 13 cases were diagnosed in Farwania hospital over a 6-year period. The clinical presentation of our patients was variable. The presence of polyps and multiple ulcerations on endoscopy is further evidence that SRUS is a misnomer. Surface serration, fibromuscular obliteration, and crypts' distortion are the most characteristic features. The presence of diamond crypts is an additional diagnostic feature.
Subject(s)
Colonoscopy/methods , Rectal Diseases/diagnosis , Ulcer/diagnosis , Actins/metabolism , Adolescent , Adult , Aged , Aged, 80 and over , Diagnosis, Differential , Female , Humans , Immunohistochemistry , Intestinal Mucosa/pathology , Male , Middle Aged , Prognosis , Rectal Diseases/metabolism , Retrospective Studies , Syndrome , Young AdultSubject(s)
Breast Neoplasms/pathology , Breast/pathology , Fibroadenoma/pathology , Adult , Breast Neoplasms/surgery , Female , Fibroadenoma/surgery , HumansABSTRACT
BACKGROUND: A condom catheter is a commonly used drainage system for incontinent patients. However, it is associated with different complications including infection and erosion. One very rare complication that has been recognized is the development of giant fibroepithelial polyps in the penis; to date, to the best of our knowledge, seven cases have been reported in the literature. We report a new case of giant fibroepithelial polyp associated with long-term condom catheter use. CASE SUMMARY: A 43-year-old incontinent man who had been using a condom catheter for 14 years following a motor vehicle accident presented with a mass on the ventral aspect of his penis; the mass had appeared a year ago. The patient underwent excisional biopsy. Grossly, there was a mass with a maximum dimension of 4.0 cm, which had an irregular surface. Histological examination revealed a fibroepithelial polyp with vascular proliferation and edematous stroma with prominent bundles of smooth muscle. Perivascular lymphoid aggregates were seen. The morphology was similar to that in the previously reported cases; the presence of smooth muscle was distinct. CONCLUSION: Giant fibroepithelial polyps can be associated with long-term condom catheter use and pathologists and urologists should be aware of this rare complication as their size can mimic carcinoma.
