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Published on: April 17, 2019
Mucosal prolapse syndrome mimicking Peutz-Jeghers syndrome in a pediatric patient
Phinga Do1, Claudia Phen1, Michele Alkalay1
1Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics University of Texas Southwestern Medical Center Dallas Texas USA.
Abstract:
Mucosal prolapse syndrome (MPS) is a rare group of benign conditions characterized by a set of unifying histologic findings thought to be the result of repeated mucosal shearing and submucosal vascular congestion caused by straining. This set of conditions is often misdiagnosed as other polyposis syndromes, inflammatory bowel disease, or malignancy due to its clinical presentation, appearance, and rarity. We report a case of a 15-year-old male who presented with painless rectal bleeding. He was found to have four rectal polyps thought to be due to Peutz-Jeghers syndrome. A repeat colonoscopy with biopsies a year later revealed a diagnosis of MPS. Our case highlights the morphologic similarity between hamartomatous polyp and mucosal prolapse histology. Since MPS is a rare diagnosis even among the adult population, it has not been well described in pediatrics. This syndrome should be on the differential diagnosis for pediatric rectal polyps to prevent unnecessary invasive testing and a delay in treatment.
Insights
Mucosal prolapse syndrome (MPS), a rare condition, can mimic other serious diseases in children. Early diagnosis in pediatric rectal polyps is crucial to avoid misdiagnosis and unnecessary procedures.
Area of Science:
- Gastroenterology
- Pediatric Pathology
Background:
- Mucosal prolapse syndrome (MPS) is a rare benign condition resulting from repeated mucosal shearing and vascular congestion.
- MPS is often misdiagnosed due to its varied clinical presentation, histologic findings, and rarity.
Observation:
- A 15-year-old male presented with painless rectal bleeding and four rectal polyps initially suspected to be Peutz-Jeghers syndrome.
- A subsequent colonoscopy with biopsies confirmed a diagnosis of MPS, highlighting its morphologic similarity to hamartomatous polyps.
Findings:
- The histological features of MPS can closely resemble other polyposis syndromes, leading to diagnostic challenges.
- This case underscores the importance of considering MPS in the differential diagnosis of pediatric rectal polyps.
Implications:
- Accurate diagnosis of MPS in pediatric patients can prevent unnecessary invasive testing and treatment delays.
- Further description of MPS in pediatric cases is needed to improve recognition and management.
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