Sessile serrated adenoma

Sessile serrated adenoma
Updated: 03/09/2022
 © Jun Wang, MD, PhD

General features
  • Combination of hyperplastic and adenomatouspolyp
  • Precursor lesion of colorectal caner
  • More common in women and smokers
  • Associated with cigarette smoking, alcohol, high BMI and fat/red meat diet
  • Usually in proximal colon
  • Serrated polyposis
    • More than 5 serrated polyps proximal to the sigmoid colon, at least 2 of these are larger than 1 cm
    • Any serrated polyps proximal to the sigmoid colon in a patient with a first degree relative with serrated polyposis syndrome
    • More than 20 serrated polyps of any size in the colon
Clinical presentations
Key morphological features
Genetic abnormalities
  • Commonly microsatellite-instability mutations and CpG island hypermethylation
  • BRAF, KRAS activation
Treatment
  • Polypectomy, complete removal recommended
  • Mucosal resection or partial colectomy if high grade dysplasia present or large polyp

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