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April 6, 1957


JAMA. 1957;163(14):1258-1259. doi:10.1001/jama.1957.02970490056013

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The existing confusion about colorectal adenomas is largely the result of their variable biological behavior pattern, which is inevitable, and partly the result of the failure of many writers to state the precise basis for their diagnosis, which is avoidable. Preventable bewilderment is also caused by the clinical use of such terms as "malignant adenoma" or "adenocarcinoma, grade 1," which are purported to connote a benign process, while the term "invasive adenoma" is applied to connote cancer. The terms "atypical" and "carcinoma in situ" appear to convey benignity to some clinicians and malignancy to others. This chaos of names has clouded our clear ideas and thoughts. The family tendency toward the development of solitary or scattered adenomas has received but scant attention.

To avoid misleading connotations, adenomas are best thought of as being either benign or malignant. Malignancy in adenomas is regarded as noninvasive or invasive, the determining or boundary

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