High-grade dysplasia in giant tubular adenoma

Year 2023, Volume: 3 Issue: 3, 29 - 33, 22.12.2023

Sami Açar Çağıl Karaevli

https://doi.org/10.58961/hmj.1354554

Abstract

Rectal adenomas with a high risk of cancer frequently occur in anal bleeding and mucus discharge. The risk of malignancy is greater than 50% in polyps larger than 2 cm and includes areas of dysplasia, and the likelihood of dysplasia is correlated with the excess of the villous component ratio, the proximity of the polyp to the anal region, and the increase in size. Large, lumen-encircling polyps are difficult to treat with endoscopic or transanal intervention and necessitate surgical intervention. In this article, we present a female patient who had rectal mucus discharge and had a lower anterior resection and coloanal anastomosis after developing a tubular adenoma with high-grade dysplasia and no villous component.

Keywords

Adenomatous polyps, biopsy, colonoscopy, colectomy

Ethical Statement

Not applicable, because this article does not contain any studies with human or animal subjects. An informed consent was obtained from the patient for this case report.

Supporting Institution

This study is entirely author's own work and no other author contribution.

Thanks

Thanks to Dr Nurten Küçükmetin for his support in the treatment process of the patient. Thanks to Dr Sevil Karabağ for his support in the pathology images of the specimen. Thanks to Dr Hadi Sasani for his support in the radiology images of the case.

Yüksek Derece Displazili Dev Tubüler Adenom

Abstract

Malignite riski yüksek olan rektal adenomlar sıklıkla anal kanama ve mukus akıntısıyla görülür. Displazi alanları içeren 2 cm'den büyük poliplerde malignite riski %50'den fazladır ve displazi olasılığı villöz komponent oranının fazlalığı, polipin anal bölgeye yakınlığı ve polip boyutunun artışı ile displazi olasılığı korele seyreder. Büyük, lümeni çevreleyen poliplerin endoskopik veya transanal girişimle tedavisi zordur ve cerrahi müdahale gerektirir. Bu yazıda; rektal mukus akıntısı ile başvuran tetkiklerinde yüksek dereceli displazili ve villöz komponent içermeyen tübüler adenomu olan kadın hastamızı, alt anterior rezeksiyon ve koloanal anastomoz yaparak tedavi ettiğimiz olguyu sunuyoruz.

Keywords

adenomatöz polipler, biyopsi, kolonoskopi, kolektomi

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