[Large adenomas of the colon and rectum--specific features of the diagnostics]

Carcinomas mostly originate from preneoplastic lesion of different origin, namely serrated and non-serrated adenomas. The probability of malignant transformation correlates to the size of the adenoma. The determining diagnostic method is colonoscopy with collection of tissue samples or endoscopic biopsies for histological investigations. For the necessary identification of the pathology some specific features of the treatment are to be followed. In future, other information, such as for example, molecular characteristics are expected from carcinoma pathways. Premalignant and malignant changes carry a row of DNA changes (e.g., a mutation in K-ras proto-oncogen). The 7th edition of the TNM classification of colorectal tumours shows minor changes in the T-, N- and M-categories and in stage grouping. It remains to be seen how far the classification into sm1 ti sm3 will be taken into consideration.