Article (Scientific journals)
Unusual intra-rectal “laterally spreading tumour” in immunosuppressed patient with ulcerative colitis
VIEUJEAN, Sophie; LATOUR, Pascale; COIMBRA MARQUES, Carla et al.
2021In Acta Gastro-Enterologica Belgica
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Keywords :
Condyloma acuminatum; rectum; intestinal spirochetosis
Abstract :
[en] Condyloma acuminatum (CA) is a manifestation of Human Papillomavirus (HPV) infection which usually occurs in genital and perianal regions. We report a 46-year-old man with an ulcerative proctitis diagnosed four years earlier, asymptomatic for a long time under azathioprine but without any follow-up for three years. A colonoscopy was performed prior to potential immunosuppressive treatment discontinuation and showed a circumferential “laterally spreading tumour” in the rectum. Surprisingly biopsies revealed a CA with a very focally high-grade intra-epithelial lesion. Azathioprine was stopped and a transanal surgical resection was performed. At guided anamnesis, patient confirmed to be a former active “men who have sex with men”. No recurrence of proctitis occurred despite azathioprine discontinuation. A retrospective review of the histological sections suggests that it was, in fact, an intestinal spirochetosis misdiagnosed as inflammatory bowel disease. Involvement of the rectal mucosa by HPV is a rare condition and this may have been promoted by inappropriate immunosuppressive treatment.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
VIEUJEAN, Sophie  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de gastroentérologie, hépatologie, onco. digestive
LATOUR, Pascale ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de gastroentérologie, hépatologie, onco. digestive
COIMBRA MARQUES, Carla ;  Centre Hospitalier Universitaire de Liège - CHU > Département de chirurgie > Chirurgie abdo, sénologique, endocrine et de transplantation
DELVENNE, Philippe ;  Centre Hospitalier Universitaire de Liège - CHU > Unilab > Service d'anatomie et cytologie pathologiques
LOUIS, Edouard  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de gastroentérologie, hépatologie, onco. digestive
VAN KEMSEKE, Catherine ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de gastroentérologie, hépatologie, onco. digestive
Language :
English
Title :
Unusual intra-rectal “laterally spreading tumour” in immunosuppressed patient with ulcerative colitis
Publication date :
September 2021
Journal title :
Acta Gastro-Enterologica Belgica
ISSN :
0001-5644
eISSN :
1784-3227
Publisher :
Acta Medica Belgica, Bruxelles, Belgium
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 20 January 2022

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