Polypoid manifestations of mucosal prolapse syndrome: a retrospective analysis of 29 cases

This retrospective study evaluated the clinical, endoscopic, and histopathological features of polypoid manifestations of mucosal prolapse syndrome (MPS). Patients diagnosed with polypoid MPS by endoscopic biopsy between December 2016 and May 2025 at two tertiary hospitals in China were included. Clinical data, endoscopic findings, histopathological features, and follow-up outcomes were analyzed. A total of 29 patients were included, comprising 17 males and 12 females, with a mean age of 50 years. Hematochezia was the most common presenting symptom, followed by anal mass prolapse and asymptomatic presentation. Lesions were predominantly located in the rectum and anal canal. A history of hemorrhoids was frequently observed and may reflect shared underlying mechanical factors rather than causality. All cases demonstrated fibromuscular obliteration of the lamina propria. Among the 19 patients with completed follow-up, delayed postoperative bleeding was uncommon; recurrence-related outcomes could not be reliably assessed because recurrence, symptom recurrence, and re-intervention data were not systematically available. This study highlights the diagnostic challenge of distinguishing polypoid MPS from neoplastic lesions owing to overlapping endoscopic features. A structured clinicopathological framework may assist in differential diagnosis and clinical decision-making.