Epithelial Displacement in Ulcerative Colitis: A Diagnostic Dilemma

Abstract A 53-year-old female with a chronic history of ulcerative colitis (UC) presented with altered bowel habits and rectal bleeding. Subsequent colonoscopy revealed a colonic stricture and an associated inflammatory polyp. Histopathological evaluation indicated epithelial displacement, which is characterized by the aberrant presence of epithelial cells at atypical locations in the colonic tissue. This phenomenon, which closely mimics invasive adenocarcinoma, posed significant diagnostic challenges. We differentiated between epithelial displacement and true malignancy by means of immunohistochemical analysis and expert pathological consultation, which culminated in a definitive diagnosis of adenocarcinoma. This case underscores the diagnostic complexities associated with epithelial displacement in the context of UC, thereby highlighting the critical role of advanced diagnostic methodologies, multidisciplinary expertise, and continued research for ensuring precise diagnosis and optimal therapeutic outcomes. Specific data on the exact number of published case reports focusing solely on epithelial displacement in UC are limited, with the literature consisting primarily of broader studies and reviews addressing this phenomenon within the context of inflammatory bowel diseases.