Flat adenoma in colon: two decades of debate

Journal of Digestive Diseases
Patrick C P Lau, Joseph J Y Sung

Abstract

The existence of flat adenomas in the colon is well recognized. Whether they represent a distinct disease with a pathogenetic pathway different from that of the classical adenoma-carcinoma sequence in colorectal tumorigenesis and have higher malignant potential remains a matter of debate. To review the epidemiology, clinical features, detection and management of flat and depressed (non-polypoid) colonic neoplasm, we performed a thorough literature review on studies focusing on the prevalence, histological features, genetics, detection and treatment of flat and depressed (non-polypoid) colonic neoplasm. A high percentage of severe dysplasia in flat colonic adenomas has not been consistently demonstrated. Their malignant potential appears to be size-dependent. Flat adenomas are found to have a lower incidence of major genetic abnormalities involved in the classical adenoma-carcinoma sequence and that has raised suspicions that they may have a different pathogenesis. The depressed type of colorectal carcinoma is uncommon but shows more aggressive behavior. More advanced colonoscopic techniques, such as chromoendoscopy, may enhance the detection of small and inconspicuous colonic neoplastic lesions that lack a protruding configurat...Continue Reading

Citations

Aug 2, 2011·Current Gastroenterology Reports·Prashant Kedia, Jerome D Waye
Jun 25, 2013·Gut·Douglas J RobertsonMaría Elena Martínez
Mar 30, 2016·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Antonio Rodríguez-D Jesus, Esteban Saperas
Apr 30, 2016·Archives of Pathology & Laboratory Medicine·Kee-Taek Jang, Sangjeong Ahn
Aug 7, 2020·Journal of Gastroenterology and Hepatology·Carlos A Rubio

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