Filiform Polyposis: Just an Ibd’s Shade or More?

1.1. Introduction Postinflammatory polyps (PIPs) are non-neoplastic lesions originating from the mucosa after repeated periods of inflammation and ulceration connected with excessive healing processes. This pattern is usually associated with Inflammatory Bowel Diseases (IBD), but rarely they can be related to different clinical conditions. PIPs can be classified into: localized, multiple, giant, generalized and filiform polyposis (FP). FP is characterized by numerous finger‑like inflammatory polyps, lined by normal colonic mucosa. If they reach up to 100 mm forming bridges and tumor-like mass, they can be defined Giant Polyposis (GP). To date, FP has not the tumoral transforming potentiality. 1.2. Results The first presented case is a 52-year-old man with a past clinical history of Ulcerative Colitis (UC) who underwent rectosigmoidoscopy for distal sigmoid obstruction and an Hartmann’s procedure was performed; the histological findings suggested a pattern consistent with an active fase of UC with a lumen obstruent FP. The other patient is a 40-year-old man who suffered from colonic substenotic episodes; the colonscopy revealed an increase in number and dimension of mucosal polyps with bridge formation. The patient underwent resection of ileum and recto-sigmoid junction with an ileocolic anastomosis T-T; the surgical specimen showed a large polypous tumor-like mass with finger-like projections with non-specific inflammatory changes and without epithelial dysplasia or neoplastic lesion. 1.3. Conclusions This short case series points out how eterogenous the presentation of FP could be: there is no certain link between IBD and FP; in addiction, these polyps can form in a generalized condition of bowel inflammation.