Giant filiform polyposis in a patient with inflammatory bowel disease presenting with intestinal obstruction

A 50-year-old known patient with ulcerative colitis with relapses and remissions presented with clinical features suggestive of bowel obstruction. Radiological studies confirmed an obstructive mass lesion in the hepatic flexure of the colon. Due to bowel obstruction and suspicion of malignancy an emergency laporatomy and partial ileo-colectomy was performed. A complex polypoid mass comprising numerous slender straight finger-like villi lined by non-neoplastic colonic mucosa with serrations at the base and prominent lamina proprial smooth muscle splaying was identified and a diagnosis of filiform polyposis was made. We report this unusual manifestation of an inflammatory reaction presenting as a colonic mass clinically and radiologically mimicking malignancy.