Cansu BENLİ IŞIK, Hatice ÖLGER UZUNER, Mustafa BAKIRTAŞ, Ahmet SARAC

Kemik Metaplazisinin Eşlik Ettiği İnflamatuar Rektal Polip: Ayrı Bir Antite mi?

Osseoz metaplazi, heterotopik kemik oluşumudur ve gastrointestinal sistemde, özellikle benign lezyonlarda nadiren karşılaşılır. Patofizyolojisi net olarak bilinmemekle birlikte bazı teoriler öne sürülmüştür. Bu olgu sunumunda, 7 yaşında bir kız çocuğunda rektal kanama ile bulgu veren kemik metaplazili inflamatuar rektal polip olgusunu sunduk. Aynı zamanda literatürü taradık ve kolon poliplerinde osseoz metaplazi olgularını özetledik. Sunulan vakalarda bunun spesifik bir antite olabileceğini düşündürten, bazı benzerlikler saptadık. Kolorektal poliplerde osseoz metaplazi oldukça nadirdir. Saptadığımız kadarıyla olgumuz osseoz metaplazi içeren on birinci rektal inflamatuar polip vakasıdır. Kolon poliplerinde osseoz metaplazi hem klinik hem de prognoz üzerinde önemli bir etkiye sahip olmasa da, mikroskopik incelemede karşılaşıldığında kafa karıştırıcı olabilir.

Anahtar Kelimeler:

Osseoz metaplazi, heterotopik ossifikasyon, rektal polip, kolon polipleri, ektopik kemikleşme

Inflammatory Rectal Polyp with Osseous Metaplasia: Is It a Distinctive Disease Entity?

Osseous metaplasia is a heterotopic bone formation and it is encountered rarely in the gastrointestinal tract, especially in benign lesions. Although its pathophysiology is not known clearly, there are several theories suggested. In this case report, we presented a case of bone formation in a rectal inflammatory polyp presenting with rectal bleeding in a 7-year-old girl. Therewithal, we reviewed the literature and summarized the subject of osseous metaplasia in colon polyps. We detected some similarities in the cases presented that suggest it might be a distinctive disease entity. Osseous metaplasia in colorectal polyps is extremely rare. To our knowledge, this is the eleventh reported case of osseous metaplasia in a rectal inflammatory polyp. Although osseous metaplasia in colon polyps has not a significant effect on both clinic and the prognosis, it can be confusing when encountered in microscopic examination.

Keywords:

osseous metaplasia, heterotopic ossification, rectal polyp, colon polyps, ectopic ossification,

PDF

___

Singh P, Nayyar A, Karandikar MN. Osseous metaplasia in hyperplastic gastric polyp -A rare case report with review of literature. Hum Pathol Case Rep. 2020;22:200439.
Stevanović D, Aleksić V, Stojanović D, Mitrović N, Jašarović D, Bokun-Vukašinović Z. Osseous metaplasia in an inflammatory polyp of the anal canal - a case report and a review of literature. Srp Arh Celok Lek. 2019;147(3-4):211-4.
Oono Y, Fu KL, Nakamura H, Iriguchi Y, Oda J, Mizutani M, et al. Bone formation in a rectal inflammatory polyp. World J Gastrointest Endosc. 2010;2(3):104-6.
Amir AA, Nouli KA, Sheikh SS. Benign prolapsing inflammatory rectal polyp with osseous metaplasia mimicking rhabdomyosarcoma botryioides. J Ped Surg Case Rep. 2020;56:101297.
Wood R, Wu T, Nakanishi Y. Osseous metaplasia in a rectal inflammatory polyp in an adolescent patient: A case report and review of the literature. Front Med Case Rep. 2020;1(2):1-5.
Zemheri E, Toprak M, Engin Zerk P, Ozkanli S, Mutus M. Inflammatory rectal polyp with osseous metaplasia. Med Med J. 2015;30(3):143-6.
McPherson F, Maldonado M, Truitt CA, Mamel JJ, Morgan MB. Metaplastic ossification of a benign colonic polyp: case report. Gastrointest Endosc. 1999;49(5):654-6.
Rothstein RD, LiVolsi VA. Metaplastic ossification of a benign colonic polyp. Gastrointest Endosc. 2000;51(2):254.
Al-Daraji WI, Abdellaoui A, Salman WD. Osseous metaplasia in a tubular adenoma of the colon. J Clin Pathol. 2005;58(2):220-1.
White V, Shaw AG, Tierney GM, Lund JN, Semeraro D. Osseous metaplasia in an ulcerating tubular adenoma of the colon: a case report. J Med Case Rep. 2008;2:130.
Wilsher MJ, Mendelsohn GB. Osseous metaplasia in a traditional serrated adenoma of the rectosigmoid colon. Pathology. 2010;42(3):302-4.
Montalvo NF, Beltrán JN, Redrobán LA. Traditional serrated adenoma of the sigmoid colon with osseous metaplasia: a case report. J Med Case Rep. 2012;6:133.
Marks MM, Atkinson KG. Heterotopic bone in a juvenile rectal polyp: Case Report. Dis Colon Rectum. 1964;7(5):345-7.
Odum BR, Bechtold ML, Diaz-Arias A. Osseous metaplasia in an inflammatory polyp of the rectum: A case report and review of the literature. Gastroenterology Res. 2012;5(2):74-8.
Ahmed R, Ahmad Z, Qureshi A. Osseous metaplasia in a juvenile retention polyp: a case report. BMJ Case Rep. 2009;2009:bcr03.2009.1650.
Bhat V, Roopa ANN, Shariff S. Juvenile rectal polyp with osseous metaplasia - A rare case with review of literature. Int J Health Sci Res. 2012;2(8):114-6.
Garg M, Kaur J, Bindroo S, Sharma A, Mahajan NC. Metaplastic ossification in a juvenile rectal polyp: A rare histological finding. J Clin Diagn Res. 2013;7(5):908-10.
Naimi A, Hosseinpour M. Osseous metaplasia in rectal polyp: A case report with review of probable pathogenesis. Adv Biomed Res. 2018;7:78.
Haynes HR, Wiskin AE, Basude D, Gradhand E. Osseous metaplasia in a juvenile rectal polyp. J Pediatr Gastroenterol Nutr. 2018;67(6):e123.
Sperling MH, Friedman CJ. Osseous metaplasia in a benign colon polyp. Gastrointest Endosc. 1981;27(3):198-9.
Bhattacharya N, Sarkar T. Osseous metaplasia in a juvenile polyp: A rare case report in India. J Clin Diagn Res. 2013;7(9):2004-5.
Lim D, Schulberg S, Suarez Y, Gadangi P. Osseous metaplasia in a recurrent symptomatic rectal lesion: a rare occurrence. Int J Colorectal Dis. 2019;34(10):1801-3.
Ansari MQ, Sachs IL, Max E, Alpert LC. Heterotopic bone formation in rectal carcinoma. Case report and literature review. Dig Dis Sci. 1992;37(10):1624-9.
Imai N, Iwai A, Hatakeyama S, Matsuzaki K, Kitagawa Y, Kato S, et al. Expression of bone morphogenetic proteins in colon carcinoma with heterotopic ossification. Pathol Int. 2001;51(8):643-8.
Kawai M, Bessho K, Kaihara S, Sonobe J, Oda K, Iizuka T, et al. Ectopic bone formation by human bone morphogenetic protein-2 gene transfer to skeletal muscle using transcutaneous electroporation. Hum Gene Ther. 2003;14(16):1547-56.