Introduction
- There are 3 types of benign polyps (hamartomas)
- hyperplastic polyp
- most common type in adults
- often rectosigmoid
- sawtoothed appearance
- does NOT predispose to malignancy
- juvenile polyps
- most common type in children
- often rectosigmoid
- hyperplastic polyp
- There are 3 types of neoplastic polyps (adenomas)
- tubular adenoma
- most common polyp
- usually pedunculated (stalked)
- tubulovillous adenoma
- usually pedunculated (stalked)
- tubular adenoma
- may involve Familial Adenomatous Polyposis
Presentation
- Sympoms
- rectal bleeding
- polyp prolapse from rectum
Evaluation
- Sigmoidoscopy / colonoscopy
- Labs
- villous adenoma may show hypokalemia and hypoalbuminemia
Differential
- Polyposis syndromes
- Juvenile polyposis
- AD inheritance
- multiple juvenile polyps in GI tract
- ↑ risk of adenocarcinoma
- Cronkhite-Canada syndrome
- Juvenile polyposis
- consists of juvenile polyposis with fingernail dystrophy
Prognosis, Prevention, and Complications
- Malignancy risk ↑ by
- ↑ size
- ↑ villous histology
- villous = villainous
- ↑ epithelial dysplasia