Management of Malignant Polyps
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Management of Malignant Polyps- Key Concepts
- References
- Overview
- Colorectal Cancer Precursor Lesions
- Colorectal Cancer Carcinogenic Pathways
- Definition of Terms: Colorectal Cancer and the Malignant Polyp
- Lesion Assessment
- Depth of Invasion
- Haggitt Classification of Pedunculated Polyps
- Kudo and Kikuchi Classification of Sessile Polyps
- Depth of Invasion and Risk of Lymph Node Metastases
- Histopathological Factors Influence the Risk of Lymph Node Metastasis in Early Colorectal Cancer
- Endoscopic Resection of Malignant Polyps
- Endoscopic Mucosal Resection (EMR) Technique
- Outcomes of EMR of Colorectal Polyps
- Endoscopic Submucosal Dissection Technique
- Outcomes of ESD for Colorectal Polyps
- Endoscopic Approach to Malignant Polyps
- Predicting the Risk of Residual Mural Cancer or Lymph Node Metastasis Following Endoscopic Resection of Malignant Polyp
- Recurrence Following Endoscopic Resection
- Surveillance After Endoscopic Resection
- Conclusion
- Endoscopic Management of Polyps and Endoluminal Surgery
Malignancy- A healthy 51-year-old man has a poorly differentiated right colon adencarcinoma with mucinous features and mismatch repair (MMR) deficient protein expression. After germline testing was performed, a diagnosis of Lynch syndrome made. The patient reports no issues with incontinence to gas or stool. What is the recommended surgery in this patient?
- A 69-year-old male patient is found to have a 1-cm tubulovillous adenoma in the sigmoid colon, with a 1-mm focus of invasive carcinoma, Haggitt level 3 with a 2-mm margin, and no adverse pathologic features. The best next step in the management of this patient is
Malignancy- A 67-year-old man recently underwent a colonoscopy with resection of a 1.2-cm pedunculated colon polyp from the sigmoid colon. The area from which the polyp was completely removed was marked with ink. Pathology showed well-differentiated adenocarcinoma invading into the submucosa of the stalk, with a 2-mm margin. No lymphovascular invasion was noted. What is the optimal management for this lesion?
- A 50-year-old man had a 1-cm sessile sigmoid polyp removed with cold snare technique in one piece and tattooed distally during screening colonoscopy. Final pathology report showed a sessile serrated adenoma with a focus of well-differentiated adenocarcinoma invading the lower third of the submucosa but not invading the muscularis propria. There is no lymphovascular invasion. Staging with computed tomography of the chest, abdomen, and pelvis is negative for metastatic disease and carcinoembryonic antigen level is normal. What is the most acceptable next step for this patient?
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