Solitary rectal cap polyp: Case report and review of the literature

Table 1 Cases of cap polyposis reviewed

No.	Case	Age (yr)	Gender	Clinical presentation	Location	Solitary vs multiple lesions	Presumed or Initial diagnosis	Treatment	Outcome
1	Campbell et al[3], 1993	68	M	Weight loss, diarrhea	Sigmoid	Multiple	UC	Total colectomy	Resolved
2	Campbell et al[3], 1993	65	F	Diarrhea	Rectum	Multiple	Solitary rectal ulcer vs infection	Sigmoid diverting colostomy/ cleversal enema	Improved
3	Géhénot et al[4], 1994	42	F	Bloody diarrhea	Recto sigmoid	Multiple	Non-specific colitis	Sigmoid colostomy	Resolved
4	Oshitani et al[5], 1998	54	F	Hypoproteinemia, diarrhea	Desc. colon	Multiple	UC	Left hemicolectomy	Resolved
5	Peny et al[6], 1998	72	M	Diarrhea, tenesmus	Rectum to ascending colon	Multiple	UC	Proctocolectomy	Resolved
6	Oriuchi et al[7], 2000	20	F	Hypoproteinemia, mucousy diarrhea	Recto sigmoid	Multiple		Avoidance of straining	Resolved
7	Oriuchi et al[7], 2000	52	F	Hypoproteinemia, mucousy diarrhea	Rectum	Multiple		Diversion transverse double barrel colostomy	Resolved
8	Kajihara et al[8], 2000	38	F	Bloody diarrhea	Recto sigmoid	Multiple	CP	Metronidazole	Resolved
9	Isomoto et al[9], 2001	51	F	Mucousy bloody diarrhea	Recto sigmoid	Multiple	Non-specific colitis	APR	Resolved
10	Esaki et al[10], 2001	21	M	Weight loss, diarrhea	Recto sigmoid	Multiple		Metronidazole	Resolved
11	Esaki et al[10], 2001	67	F	Abdominal pain, mucousy diarrhea	Recto sigmoid	Multiple		Anterior resection	Resolved
12	Esaki et al[10], 2001	21	M	Abdominal pain	Rectum	Multiple		Patient refused
13	Esaki et al[10], 2001	76	F	Diarrhea, tenesmus	Recto sigmoid	Multiple		Patient refused	Resolved
14	Sadamoto et al[11], 2001	73	M	Asymptomatic	Sigmoid to cecum	Multiple	CP	Observation	Resolved
15	Oiya et al[12], 2002	63	M	Mucousy diarrhea	Rectum to ascending colon	Multiple		H. pylori eradication therapy	Resolved
16	Shimizu et al[13], 2002	12	F	Mucousy bloody diarrhea	Recto sigmoid	Multiple	UC	Metronidazole	Resolved
17	Park et al[14], 2002	60	F	Tenesmus	Rectum			Low anterior resection	Resolved
18	Ohkawara et al[15], 2003	67	F	Mucousy bloody diarrhea	Recto sigmoid	Multiple	Non-specific colitis	Patient refused	Resolved
19	Akamatsu et al[16], 2004	33	F	Hypoproteinemia, mucousy bloody diarrhea	Rectum	Multiple	UC	H. pylori eradication therapy	Resolved
20	Akamatsu et al[16], 2004	50	F	Weight loss, diarrhea	Recto sigmoid	Multiple	CP	H. pylori eradication therapy	Resolved
21	Akamatsu et al[16], 2004	53	F	Mucousy bloody diarrhea	Recto sigmoid	Multiple	CP	H. pylori eradication therapy	Resolved
22	Bookman et al[17], 2004	36	F	Mucousy bloody diarrhea	Recto sigmoid	Multiple	CP	Infliximab	Resolved
23	Maunoury et al[18], 2005	52	F	Mucousy diarrhea	Rectum	Multiple	CP (recurrence)	Infliximab	Failed
24	Konishi et al[19], 2005	76	F	Hypoproteinemia, Mucousy bloody diarrhea	Through out the colon	Multiple	CP	Sigmoidectomy for villous adenoma	Resolved
25	Ryu et al[20], 2006	64	M	Weight loss, diarrhea	Recto sigmoid	Multiple	CP	Observation	Resolved
26	Nakagawa et al[21], 2009	52	F	Weight loss, mucousy bloody diarrhea	Rectum to transverse colon	Multiple	CP	H. pylori eradication therapy	Resolved
27	Kim et al[22], 2009	53	F	Mucousy bloody diarrhea, tenesmus	Recto sigmoid	Multiple	Pseudomembranous colitis	Infliximab	Resolved
28	Obusez et al[23], 2010	70	F	Diarrhea	Ileal pouch	Solitary	CP	Piecemeal snare polypectomy	Resolved
29	Yang et al[24], 2010	67	F	Epigastric pain, nausea	Stomach	Multiple		H. pylori eradication therapy	Resolved
30	Present case	21	M	Blood loss p.a.	Lower rectum	Solitary	Rectal cancer	Piecemeal snare polypectomy	Resolved

CP: Cap polyposis; UC: Ulcerative colitis; H. pylori: Helicobacter pylori.

Table 2 Symptoms of cap polyposis

Symptoms	%
Mucousy diarrhea	86.7
Bloody stool	33.3
Weight loss	10
Abdominal pain	10
Tenesmus	10