Sessile serrated adenoma
Sessile serrated adenoma
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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
- Usually asymptomatic
- Endoscopic findings of flat or sessile polyps covered by mucous
Key morphological features
- Both adenomatous and hyperplasic changes
- Mixed features of adenomatous and hyperplasic polyps
- Basal crypt dilation
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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