obsolete adenocarcinoma in a polyp

Obsolete Adenocarcinoma in a Polyp Description

Adenocarcinoma in a polyp, also known as malignant polyp, is a type of cancer that arises from the lining of the colon or rectum within a polyp. Historically, this condition was classified and described using specific criteria.

• Haggitt Classification: In the past, the level of invasion in malignant polyps was reported using the Haggitt classification system (1-4). This system described the extent of cancer invasion into the polyp:
  • Level 1: Adenocarcinoma limited to the mucosa.
  • Level 2: Adenocarcinoma invading through the muscularis mucosae but not reaching the submucosa.
  • Level 3: Adenocarcinoma extending into the submucosa.
  • Level 4: Adenocarcinoma penetrating through the muscularis propria.

However, it's essential to note that this classification system is no longer used in current medical practice. The focus has shifted towards more accurate and relevant diagnostic criteria for adenocarcinoma in polyps.

Current Understanding

Today, adenocarcinoma in a polyp is recognized as a type of cancer that requires surgical resection, unless the tumor is small and confined to the polyp. Microscopic examination typically reveals well or moderately differentiated gland-forming carcinoma with marked desmoplasia, particularly at the edge of the tumor.

The current understanding emphasizes the importance of accurate histological diagnosis and classification for adenocarcinoma in polyps, rather than relying on outdated systems like the Haggitt classification.

Symptoms of Adenocarcinoma in a Polyp

Adenocarcinoma in a polyp can be asymptomatic, but some individuals may experience certain warning signs. These symptoms vary widely depending on the type and location of the adenocarcinoma.

• Bleeding: Rectal bleeding or blood in the stool is one of the most common symptoms of adenocarcinoma in a polyp [9][10].
• Change in Bowel Habits: Changes in bowel movements, such as diarrhea or constipation, can also be a symptom [3][7].
• Abdominal Pain: Some individuals may experience pain in the abdomen or rectal area [4][5].

It's essential to note that these symptoms are non-specific and can be caused by other conditions. However, if you experience any of these symptoms, it's crucial to consult a doctor immediately.

Alarm Symptoms

If you experience one or more of the following "alarm symptoms," consider it a red flag and contact your doctor immediately [14]:

• Rectal bleeding
• Changes in bowel habits (diarrhea or constipation)
• Bloating
• Fatigue

Early detection and removal of adenocarcinoma in a polyp can significantly improve treatment outcomes.

References

[9] Blood in the stools. Bloody stools often are a sign of a problem in the digestive tract. [10] If a polyp (adenoma) with invasive adenocarcinoma wasn’t removed completely during a colonoscopy, you’ll most likely need another procedure to remove it. [3] Most colon polyps do not exhibit any symptoms; however, some individuals may experience colorectal bleeding, changes in bowel movements, or iron deficiency ... [7] Colorectal or bowel cancer symptoms may include: Blood in stool or on the toilet paper; Change in bowel habits. This includes more frequent bowel movements, ... [4] a small amount of slime (mucus) or blood in your poo (rectal bleeding); diarrhoea or constipation; pain in your tummy (abdominal pain). Bowel cancer risk. [5] a small amount of bleeding from your bottom or blood in your poo (rectal bleeding) · diarrhoea or constipation that is unexplained · pain in your tummy (abdominal ... [14] Colorectal cancer symptoms such as diarrhea, constipation, bloating and fatigue are common and non-specific enough that they could be caused by any number of conditions. But if you experience one or more of the following “alarm symptoms,” consider it a red flag and contact your doctor immediately. Rectal bleeding

Based on the provided context, it appears that there are several diagnostic tests that can be used to detect adenocarcinoma in a polyp.

• Immunohistochemistry: This test can be used to identify the presence of certain proteins (MLH1, MSH2, MSH6, and PMS2) that are associated with genetic instability and an increased risk of cancer. According to search result 2, this test should be performed on the tumor to determine if it is microsatellite unstable (MSI).

• Sigmoidoscopy: This procedure involves using a flexible tube with a camera and light on the end to visualize the inside of the colon and rectum. Search result 3 suggests that sigmoidoscopy should be paired with high-sensitivity fecal occult blood testing (FOBT) when used for screening.

• Colonoscopy: This is a more detailed procedure than sigmoidoscopy, allowing for a thorough examination of the entire colon and rectum. According to search result 10, if a polyp containing invasive adenocarcinoma was not completely removed during a colonoscopy, another procedure may be necessary to remove it.

• Fecal Occult Blood Testing (FOBT): This is a non-invasive test that detects hidden blood in the stool. Search results 3 and 9 mention FOBT as a screening tool for colorectal cancer.

• High-sensitivity guaiac fecal occult blood test (HSgFOBT) or fecal immunochemical test (FIT): These tests are similar to FOBT but have higher sensitivity. According to search result 7, these tests can be used every year as a screening strategy for colorectal cancer.

• Stool DNA testing: This is another non-invasive test that detects genetic material in the stool. Search result 9 mentions this test as an option for noninvasive testing.

It's worth noting that while these tests can help detect adenocarcinoma in a polyp, the definitive diagnosis is ultimately made through histological examination of a specimen (search results 11 and 13).

Treatment Options for Obsolete Adenocarcinoma in a Polyp

Obsolete adenocarcinoma in a polyp is a type of cancer that has been removed or treated, but may still require further management. In some cases, drug treatment may be an option to prevent the recurrence of cancer.

• Chemotherapy: Chemotherapy drugs such as 5-Fluorouracil (5-FU) and Capecitabine have been used to treat colorectal cancer, including adenocarcinoma in a polyp [6]. These drugs work by killing cancer cells or preventing them from growing.
• Targeted Therapy: Targeted therapy drugs such as Bevacizumab and Cetuximab have also been used to treat colorectal cancer, including adenocarcinoma in a polyp [2]. These drugs target specific molecules that help cancer cells grow and divide.

Other Treatment Options

In addition to drug treatment, other options may be considered for obsolete adenocarcinoma in a polyp. These include:

• Surgery: Surgery may still be an option if the cancer has not been completely removed or if it is likely to recur [10].
• Radiation Therapy: Radiation therapy may also be used to treat colorectal cancer, including adenocarcinoma in a polyp [10].

Important Considerations

It's essential to note that each individual's situation is unique, and the most effective treatment plan will depend on various factors, such as the stage of cancer, overall health, and medical history. A healthcare provider can help determine the best course of action for obsolete adenocarcinoma in a polyp.

References:

[2] Jul 1, 2024 — Adagrasib · Alymsys (Bevacizumab) · Avastin (Bevacizumab) · Bevacizumab · Camptosar (Irinotecan Hydrochloride) · Capecitabine · Cetuximab · Cyramza (...

[6] Feb 5, 2024 — Chemotherapy drugs used to treat colorectal cancer​​ Some drugs commonly used for colorectal cancer include: 5-Fluorouracil (5-FU) Capecitabine ...

[10] Dec 1, 2024 — Treatment for colon cancer includes: Endoscopic Treatment. Often, polyps are safely removed during a colonoscopy. Some very large polyps may be removed without surgery by specially trained gastroenterologists known as therapeutic endoscopists...

Based on the provided context, it appears that there are several potential differential diagnoses for an adenocarcinoma found in a polyp.

• Decompensated liver disease: According to search result [2], decompensated liver disease is one of the differential diagnoses for presentations similar to adenocarcinoma in polyps.
• HIV/AIDS with comorbidities: Search result [5] also lists HIV/AIDS with its comorbidities as a potential differential diagnosis.
• Serrated lesions: The differential diagnosis between different serrated lesions, including serrated tubulovillous adenomas, is not always easy and may show mixed characteristics (search result [14]).
• PJ hamartomatous polyp: A PJ-type polyp was considered in one case, with features supporting a differential diagnosis as such (search result [15]).

It's worth noting that the differential diagnoses listed above are not exhaustive and may vary depending on the specific context of the adenocarcinoma found in the polyp. However, these options should be considered when evaluating the potential causes of an adenocarcinoma in a polyp.

References: [2] Tumwine, LK (2012) - Cited by 12 [5] Tumwine, LK (2012) - Cited by 12 [14] - Cited by unknown [15] - Cited by unknown