Recurrent colonic polyps

Mucosal biopsies showed chronic active inflammation in the intervening mucosa in keeping with ulcerative colitis but there was no neoplasia in the lesional biopsies. The resection specimen showed a large, friable, carpet-like polypoid mass within the ascending colon measuring 170×180 mm with other small polypoid lesions proximally. GIP is an uncommon benign lesion, usually associated with IBD.1–3 Small inflammatory pseudopolyps are commonly seen in long-standing IBD and represent inflamed regenerating mucosa that projects above the level of the surrounding mucosa.4 Rarely, they can form large polyps, typically in the transverse or descending colon, forming a tumour-like mass, mimicking malignancy.3 These giant polyps occur in Crohn’s disease and ulcerative colitis with similar frequency.4 They can also occur occasionally in diverticular disease of the sigmoid colon.5 Clinically, patients with GIP may have symptoms and signs similar to IBD including diarrhoea, rectal bleeding and anaemia, but the spectrum is varied, ranging from asymptomatic patients to patients presenting with colonic obstruction.3 6 Patients with GIP will often undergo colectomy due to clinical concerns of malignancy and frequent presentation with colonic obstruction.