Dysplasia-associated polypoid mucosal lesion in a pelvic pouch after restorative proctocolectomy for ulcerative colitis

A 32-year-old man with ulcerative colitis had a colectomy for toxic colitis . Later, a rectal mucosectomy was performed along with the creation of a pe lvic pouch. In 1998, approximately 10 years after this staged restorative p roctocolectomy was completed, endoscopic examination of the pelvic pouch de tected a small mucosal polypoid mass lesion. Although the lesion had the ma croscopic appearance of an inflammatory polyp, microscopic sections of the resected lesion revealed dysplastic changes. Endoscopic polypectomy was per formed to remove the lesion, and further histological surveillance examinat ions of the pelvic Pouch have not detected additional dysplastic mucosal ch anges.