AME case reports · 2026
Endoscopic submucosal dissection for colitis cystica profunda in a 49-year-old woman: a case report with 52-month follow-up and sustained remission.
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Guan Liyu, Ouyang Rong, Li Zhongzhuan, Tang Wei, Chen Zhixin
Аннотация
BACKGROUND: Colitis cystica profunda (CCP) is a rare benign colorectal lesion characterized by mucus-filled cysts within the submucosa. However, the durability of endoscopic submucosal dissection (ESD) for CCP beyond 48 months has not been documented. This case aims to fill that gap. ESD has emerged as a minimally invasive approach enabling both definitive diagnosis and treatment, but data on long-term efficacy remain limited, with no reported follow-up exceeding 48 months.
CASE DESCRIPTION: A 49-year-old woman presented with a 6-month history of unformed stools. Colonoscopy revealed a submucosal mound-like lesion in the rectum, 5 cm from the anal verge. Endoscopic ultrasonography (EUS) showed hypoechoic areas (0.4 cm × 0.2 cm) confined to the muscularis mucosa and submucosa, suspicious for a neuroendocrine tumor. Routine laboratory tests (complete blood count, C‑reactive protein, carcinoembryonic antigen) were within normal limits. ESD was performed for en bloc resection. Histopathological examination demonstrated cystica dilated glands in the submucosa lined by benign colonic epithelium with surrounding fibrotic stroma and chronic inflammatory infiltration, confirming the diagnosis of CCP. No cytologic atypia was observed. The patient was followed with serial colonoscopy at 12, 40, and 52 months post-ESD, and with contrast‑enhanced magnetic resonance imaging (MRI) at 12 months. Functional outcomes were assessed using the Wexner Constipation Score (0/30) and 36-Item Short Form Health Survey (SF-36) questionnaire (scores comparable to population norms). All follow‑up examinations showed stable scar‑like changes without evidence of recurrence, and the patient maintained normal bowel habits (formed stools 1-2 times daily).
CONCLUSIONS: This case provides preliminary evidence that ESD can achieve durable remission and excellent functional outcomes in a single patient with CCP over 52 months. However, these findings are from one case and require confirmation in larger, prospective studies.
CASE DESCRIPTION: A 49-year-old woman presented with a 6-month history of unformed stools. Colonoscopy revealed a submucosal mound-like lesion in the rectum, 5 cm from the anal verge. Endoscopic ultrasonography (EUS) showed hypoechoic areas (0.4 cm × 0.2 cm) confined to the muscularis mucosa and submucosa, suspicious for a neuroendocrine tumor. Routine laboratory tests (complete blood count, C‑reactive protein, carcinoembryonic antigen) were within normal limits. ESD was performed for en bloc resection. Histopathological examination demonstrated cystica dilated glands in the submucosa lined by benign colonic epithelium with surrounding fibrotic stroma and chronic inflammatory infiltration, confirming the diagnosis of CCP. No cytologic atypia was observed. The patient was followed with serial colonoscopy at 12, 40, and 52 months post-ESD, and with contrast‑enhanced magnetic resonance imaging (MRI) at 12 months. Functional outcomes were assessed using the Wexner Constipation Score (0/30) and 36-Item Short Form Health Survey (SF-36) questionnaire (scores comparable to population norms). All follow‑up examinations showed stable scar‑like changes without evidence of recurrence, and the patient maintained normal bowel habits (formed stools 1-2 times daily).
CONCLUSIONS: This case provides preliminary evidence that ESD can achieve durable remission and excellent functional outcomes in a single patient with CCP over 52 months. However, these findings are from one case and require confirmation in larger, prospective studies.