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Malignant potential in flat elevations

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

Ninety-nine colonoscopically removed flat elevations were examined. They were divided into two groups: Group 1—flat elevations 1 to 5 mm in diameter (55 cases)- and Group 2—flat elevations 6 to 10 mm in diameter (44 cases). Group 2 had a higher percentage of adenomas (86.4 percent) than Group 1 (67.3 percent). In adenoma cases (flat adenomas), Group 2 tended to show a higher degree of dysplasia. The rates of mild and moderate dysplasia were 83.8 percent and 16.2 percent in Group 1vs.1.70 percent and 13.2 percent in Group 2, respectively. Group 2 contained six cases (15.8 percent) of intramucosal carcinoma (severe dysplasia), while there were no cancer cases in Group 1. Both malignancy rate and degree of dysplasia were size dependent; the larger the lesion the more severe the dysplasia. Our study also revealed that small flat elevations tend to contain higher numbers of nonneoplastic lesions than do larger lesions. Increased detection of nonneoplastic lesions seems to have contributed to an overall decline in the malignancy rate of flat elevations in recent reports.

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References

  1. Muto T, Kamiya J, Sawada T,et al. Small “flat elevation” of the large bowel with special reference to its clinico-pathological features. Stomach Intest 1984;19:1359–66.

    Google Scholar 

  2. Muto T, Kamiya J, Sawada T,et al. Small “flat adenoma” of the large bowel with special reference to its clinicopathologic features. Dis Colon Rectum 1985;28:847–51.

    PubMed  CAS  Google Scholar 

  3. Morson BC. Precancerous and early malignant lesions of the large intestine. Br J Surg 1968;55:725–31.

    PubMed  CAS  Google Scholar 

  4. Muto T, Bussey HJ, Morson BC. The evolution of cancer of the colon and rectum. Cancer 1975;36:2251–70.

    PubMed  CAS  Google Scholar 

  5. Lane N. The precursor tissue of ordinary large bowel cancer. Cancer Res 1976;36:2669–72.

    PubMed  CAS  Google Scholar 

  6. Lescher TC, Dockerty MB, Jackmann RJ, Beahrs OH. Histopathology of the large colonic polyp. Dis Colon Rectum 1967;10:118–24.

    PubMed  CAS  Google Scholar 

  7. Fenoglio CM, Lane N. The anatomical precursor of colorectal carcinoma. Cancer 1974;34:819–23.

    PubMed  Google Scholar 

  8. Muto T, Adachi M, Sawada T. Endoscopic and histological features of small early carcinomas of the colon with special reference to flat elevation and IIa type carcinoma. Stomach Intest 1987;22:397–406.

    Google Scholar 

  9. Muto T, Sawada T, Konishi F,et al. Endoscopic diagnosis and management of colonic polyps. Gan To Kagaku Ryoho 1986;13:2273–81.

    PubMed  CAS  Google Scholar 

  10. Muto T, Sawada T. Management of flat and depressed type of early colorectal carcinoma. Gastroenterol Surg 1991;14:317–25.

    Google Scholar 

  11. Shinya H, Wolff WI. Morphology, anatomic distribution and cancer potential of colonic polyps. Ann Surg 1979;190:679–83.

    PubMed  CAS  Google Scholar 

  12. Konishi F, Morson BC. Pathology of colorectal adenomas: a colonoscopic survey. J Clin Pathol 1989;35:830–6.

    Google Scholar 

  13. Vogelstein B, Fearon ER, Hamilton SR, Kern SE. Genetic alterations during colorectal tumor development. N Engl J Med 1988;319:525–32.

    Article  PubMed  CAS  Google Scholar 

  14. Vogelstein B, Fearon ER, Kern SE,et al. Allelotype of colorectal carcinomas. Science 1989;244:207–11.

    PubMed  CAS  Google Scholar 

  15. Muto T, Kamiya J, Sawada T,et al. Colonoscopic polypectomy in diagnosis and treatment of early carcinoma of the large intestine. Dis Colon Rectum 1980;23:68–75.

    PubMed  CAS  Google Scholar 

  16. Robert AW, David AO. Flat adenomas of the colon. Hum Pathol 1991;22:70–4.

    Article  PubMed  Google Scholar 

  17. Shinya H, Wolf WI. Morphology, anatomic distribution and cancer potential of colonic polyps. Ann Surg 1979;190:679–83.

    PubMed  CAS  Google Scholar 

  18. Muto T, Kamiya J, Konishi H, Sawada T, Sugihara K, Kusama S. Pathology of colonic polyps with special reference to malignant potential of adenomas. Saishin-IGAKU 1981;36:80–7.

    Google Scholar 

  19. Sawada T, Muto T, Kamiya J, Konishi F, Sugihara K, Kusama S. The value of colonoscopic diathermybiopsy (“hot-biopsy”) for tiny colonic polyps. Gastroenterol Endosc 1981;23:1130–9.

    Google Scholar 

  20. Muto T, Kamiya J, Sawada T,et al. Colonoscopic polypectomy in diagnosis and treatment of early carcinoma of the large intestine. Dis Colon Rectum 1980;23:68–75.

    PubMed  CAS  Google Scholar 

  21. Muto T, Konishi F, Sawada T, Adachi M, Morioka Y. Colonoscopic polypectomy as a tool for management of colonic polyps and detection of new lesions. Ann Acad Med Singapore 1987;16:427–31.

    PubMed  CAS  Google Scholar 

  22. Ohkura Y, Nakamura K. Histopathological study on the histogenesis of colorectal carcinoma. Stomach Intest 1987;22:431–41.

    Google Scholar 

  23. Adachi M, Muto T, Morioka Y, Ikenaga T, Hara M. Flat adenoma and flat mucosal carcinoma (IIb type)—a new precursor of colorectal carcinoma? Report of two cases. Dis Colon Rectum 1988;31:236–43.

    PubMed  CAS  Google Scholar 

  24. Spratt JS Jr, Ackermann LV, Moyer CA. Relationship of polyps of the colon to colonic cancer. Ann Surg 1958;148:682–96.

    PubMed  Google Scholar 

  25. Spratt JS Jr, Ackermann LV. Small primary carcinoma of the colon and rectum. JAMA 1962;17:337–46.

    Google Scholar 

  26. Castleman B, Krickstein HI. Do adenomatous polyps of the colon become malignant? N Engl J Med 1962;267:469–74.

    Article  CAS  PubMed  Google Scholar 

  27. Crawford BE, Stromeyer FW. Small nonpolypoid carcinomas of the large intestine. Cancer 1983;51:1760–3.

    PubMed  CAS  Google Scholar 

  28. Spjut HJ, Frankel NB, Appel MF. The small carcinoma of the colon and rectum. Am J Surg 1979;190:679–83.

    Google Scholar 

  29. Shamsuddin AK, Kato Y, Kunishima N, Sugano H, Trump BF. Carcinoma in situ in nonpolypoid mucosa of the large intestine: report of a case with significance in strategies for early detection. Cancer 1985;56:2849–54.

    PubMed  CAS  Google Scholar 

  30. Muto T, Adachi M, Sugihara K, Sawada T, Masaki T, Morioka Y. Clinicopathologic features of flat adenoma of the large bowel. In: Utsunomiya J, Lynch H, eds. Hereditary colorectal cancer. Tokyo: Springer-Verlag, 1990:351–6.

    Google Scholar 

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Watanabe, T., Sawada, T., Kubota, Y. et al. Malignant potential in flat elevations. Dis Colon Rectum 36, 548–553 (1993). https://doi.org/10.1007/BF02049860

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