[Endoscopic polypectomy and adenoma-carcinoma sequence of the large intestine. Considerations on personal case...

Since the introduction of colonoscopic polypectomy, the management of colonic polyps has dramatically changed. What once was a major transabdominal operation now is a routine therapeutic endoscopic procedure. To test the hypothesis of the adenoma-carcinoma sequence histopathologic features of polypoid lesions are retrospectively evaluated. In our experience with 566 polypectomies 430 adenomatous polyps, 71 hyperplastic, 58 inflammatory polyps, and 4 juvenile lesions are reported. Only adenomatous polyps showed dysplasia. Overall, severe and moderate dysplasia was respectively observed in 6.7% and 23% of the adenomas. Infiltrating carcinoma was present in 2.2% of the cases. Villous adenomas showed high rates of severe dysplasia (37%) and invasive carcinoma (18%). Location and sex did not seem to have a role in the malignant potential of adenomas.