Intestinal obstruction caused by giant filiform polyposis in a patient with normal colon

A 31-year-old patient with no previous history of inflammatory bowel disease (IBD) underwent further evaluation for recurrent episodes of intestinal obstruction. Abdominal computed tomography revealed thickening of the wall of the ascending colon and dilated small-bowel loops (●" Fig.1). Colonoscopy disclosed a large polypoid mass with fingerlike projections in the right colon (●" Fig.2). Progression of the endoscope beyond this point was not possible. Biopsies were negative for malignancy. Prompted by the suspicious endoscopic appearance of the lesion and the signs of intestinal obstruction, a right-sided hemicolectomy was carried out. The resected specimen included a mass with multiple clustered polyps with several branches that almost completely obliterated the lumen of the colon (●" Fig.3). Microscopic examination was consistent with giant filiform polyposis (●" Fig.4). The nonpolypoid mucosa of Fig.1 Computed tomography (CT) in a 31-year-old patient presenting with recurrent episodes of intestinal obstruction but with no previous history of inflammatory bowel disease (IBD). The wall of the right colon is thickened (asterisk) with intraluminal fingerlike lesions (arrow) and dilated small bowel loops (arrowhead). Fig.2 Colonoscopic view of the polypoid mass obstructing the lumen of the right colon.