Colitis cystica profunda diagnosed by laparoscopic excision: A case report and review of literature.

BACKGROUND: Colitis cystica profunda (CCP) is a rare condition with multiple cystic lesions in the mucosal/submucosal layers, predominantly involving the rectum and sigmoid colon. Its etiology remains unclear, with mucinous neoplasms and polyps as major differential diagnoses. Nonspecific imaging and clinical manifestations make preoperative diagnosis challenging (most confirmed postoperatively). This report summarizes reported cases, adds a new one, and compares it with 106 prior cases to enhance understanding of its features, diagnosis and management.

CASE SUMMARY: Herein, we report a 32-year-old man with a history of colonoscopy detection of two submucosal colonic elevations (20 cm and 18 cm from the anal verge) 2 weeks ago, without any disturbing symptoms. Endorectal ultrasound showed two cystic masses in the sigmoid's intrinsic muscular and submucosal layers. Computed tomography showed rectosigmoid thickening. We performed a laparoscopic operation to remove the lump. Final pathology was diagnosed with CCP. The patient was discharged five days later and had follow-up visits with no signs of relapse for a period of 3 months.

CONCLUSION: CCP is rare and the clinical symptoms are not typical, and pre-operative diagnosis is difficult. Histopathology is required for definitive diagnosis. Surgical excision is widely reported as the surgical treatment of choice for CCP.