THE MANAGEMENT of adenomatous polyps of the colon is a controversial subject. We have taken an approach that utilizes the points of agreement among clinicians, radiologists, and pathologists to offer a rational basis for the diagnosis and treatment of these lesions.
Pathologists agree that an adenomatous polyp on a long stalk is at most a lesion of low-grade clinical malignancy. Even if the head of the polyp histologically harbors carcinoma cells, these cells rarely traverse the pedicle into adjacent lymph nodes. Grinnell and Lane,1 in a series of 2,000 patients, did not find a single patient who had a polyp on a long stalk with a head measuring less than 1.5 cm in whom metastasis had occurred. Enterline2 recently restated this view, noting that he had never seen metastasis when a carcinoma is confined to the head of a polyp on a stalk. Ackerman and Spratt,3 Castleman
Marshak RH, Lindner AE, Maklansky D. Adenomatous Polyps of the Colon: A Rational Approach. JAMA. 1976;235(26):2856–2858. doi:10.1001/jama.1976.03260520050028
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