J Clin Pathol 62:1034-1036 doi:10.1136/jcp.2009.067801
  • Case report

Mucosal prolapse syndrome presenting as rectal polyposis

  1. L A A Brosens1,
  2. E A Montgomery2,
  3. B S Bhagavan2,
  4. G J A Offerhaus1,
  5. F M Giardiello3
  1. 1
    Department of Pathology, University Medical Center, Utrecht, The Netherlands
  2. 2
    Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
  3. 3
    Department of Medicine, Division of Gastroenterology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
  1. Correspondence to Lodewijk A A Brosens, Department of Pathology (H04-312), University Medical Center Utrecht, Postbox 85500, 3508 GA Utrecht, The Netherlands; L.A.A.Brosens{at}
  • Accepted 12 May 2009


Mucosal prolapse syndrome comprises a variety of clinical and histopathological entities, with mucosal prolapse as the underlying pathogenic mechanism. Due to variable clinical, endoscopic and histopathological presentation and rareness of symptomatic mucosal prolapse, misdiagnosis resulting in delayed or inappropriate treatment is frequent. This report describes a patient initially diagnosed with a colorectal polyposis syndrome consisting of multiple rectal hyperplastic and adenomatous polyps. But after careful review of medical history and histopathology, the patient was found to have a rare variant of solitary rectal ulcer syndrome presenting as rectal polyposis. The recognition of rectal polyposis as a manifestation of solitary rectal ulcer syndrome/mucosal prolapse syndrome will improve diagnosis and treatment and prevent inappropriate management of this condition.


  • Funding F M Giardiello is financially supported by The John G Rangos Sr Charitable Foundation, The Clayton Fund and NIH grant P50 CA 93-16.

  • Competing interests None.

  • Ethics approval Ethics approval was obtained from the research review committee of the University Medical Center, Utrecht, The Netherlands.

  • Provenance and peer review Not commissioned; not externally peer reviewed.