Korean J Gastroenterol.  2020 Sep;76(3):159-163. 10.4166/kjg.2020.76.3.159.

Serrated Polyposis Syndrome with a Synchronous Colon Adenocarcinoma Treated by an Endoscopic Mucosal Resection

• Lee SH
• Lee SJ
• Park SC
• Nam SJ
• Kang MH
• Kim TS
• Lee SK

• KMID: 2506672
• DOI: http://doi.org/10.4166/kjg.2020.76.3.159

Abstract

Serrated polyposis syndrome (SPS) can transform to malignant lesions through the sessile serrated pathway and traditional serrated pathway. These pathways may cause rapid neoplastic progression compared to the adenoma-carcinoma sequence, which may cause interval colorectal cancer. The authors experienced a case of SPS with a synchronous colon adenocarcinoma that was treated with an endoscopic mucosal resection. In pathology reviews, other parts of the adenocarcinoma showed sessile serrated adenoma. Therefore, patients with SPS have a potential for malignant transformation, highlighting the need for strict colonoscopy surveillance starting at the time of SPS diagnosis.

Keyword

Intestinal polyposis; Adenocarcinoma; Endoscopic mucosal resection

Figure

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  Fig. 1 (A) Colonoscopic finding showing a polyp in the sigmoid colon identified as well-differentiated adenocarcinoma. (B) Histology examination showing focal high-grade dysplasia (black arrow), suggesting well-differentiated adenocarcinoma and epithelial serration with extension to the crypt bases (blue arrow), suggestive of a sessile serrated adenoma (H&E, ×100).

• 

  Fig. 2 Colonoscopic findings showing multiple polyps with variable sizes in the (A) rectum, (B) sigmoid colon, (C, D) descending colon.

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  Fig. 3 (A) Colonoscopy finding revealed a 1.4 cm sized polyp in the sigmoid colon. (B) Histologic features of the lesion revealed elongated glands and crypts with serration in the upper-third of the mucosa (H&E, ×100).

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