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The malignant adenoma: when to operate and when to watch

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Abstract

Background

Adenomas are the precursors to colorectal cancer. Malignant adenomas represent an early form of colorectal cancer, in which cancer has invaded by direct continuity through the muscularis mucosa into the submucosa. The management of these malignant adenomas depends upon their histological risk factors and the patient’s general condition.

Methods

A literature review of publications regarding the malignant adenoma/polyp using Medline was performed.

Results

The three main histological characteristics associated with an increased risk of residual disease and the potential for metastases are completeness and margin of excision, degree of differentiation and Haggitt level of invasion.

Conclusion

The dilemma as to which course of action is in the best interest of the patient with high-risk adenoma, be it either therapeutic polypectomy alone or surgical resection, is best resolved by a multidisciplinary team involving the surgeon, pathologist and endoscopist, taking the patient’s condition and wishes into account.

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Authors and Affiliations

  1. Department of Surgery, Wythenshawe Hospital, South Manchester University Hospitals Trust, Southmoor Road, Wythenshawe, Manchester, UK

    Peter J. Mitchell

  2. Department of Surgical Pathology, Trafford Healthcare NHS Trust, Davyhulme, Manchester, M41 5SL, UK

    Najib Y. Haboubi

Authors
  1. Peter J. Mitchell
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  2. Najib Y. Haboubi
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Correspondence to Najib Y. Haboubi.

Additional information

Read at the 18th Annual International Colorectal Disease Symposium, Harbour Beach Marriott, Fort Lauderdale, Florida, Wednesday 14 February 2007.

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Mitchell, P.J., Haboubi, N.Y. The malignant adenoma: when to operate and when to watch. Surg Endosc 22, 1563–1569 (2008). https://doi.org/10.1007/s00464-008-9850-y

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  • DOI: https://doi.org/10.1007/s00464-008-9850-y

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