Colonic adenoma, reflux esophagitis
April 27, 2010 | 100,00 EUR | answered by Dr. med. Olaf Stephan
Dear Sir or Madam,
I am reporting to you the histological results of my endoscopic examination.
This result indicates... what treatment options are available... how quickly do I need to receive treatment... what do you advise me...
I am a 59-year-old male.
30 cm (HE) Two polyp components, totaling 2.5 cm in size.
Components of a tubulovillous adenoma with high-grade intraepithelial neoplasia and pronounced pseudoinvasion with individual mucous lakes and abundant hemosiderin-storing macrophages, as well as extensions of the pseudo-invaded adenoma reaching the basal resection line.
Dear Inquirer,
for the precise answer to your question, knowledge of the endoscopic findings is also necessary. Without a doubt, the extracted adenomas with high-grade intraepithelial dysplasia represent a so-called precancerous condition, meaning that from these mucosal changes, a malignant tumor in the form of colon cancer is likely to develop in the next few years. Therefore, the examination carried out as part of screening and early detection has been successful and gives you the opportunity to continue living without a high risk of tumor and without a major operation. If the relevant adenomas were completely removed, for example with a snare during colonoscopy, you can consider yourself cured, and you only need to pay attention to regular follow-up examinations (colonoscopy) every three to five years, depending on the size and number of removed polyps. However, it is also evident from the histological report you mentioned that at least one adenoma was incompletely or questionably completely removed (extension of the adenoma to the basal resection line). In this case, a short-term follow-up colonoscopy in about 4-6 weeks is recommended to evaluate and possibly re-remove any remaining adenoma tissue, as these also have the potential to become malignant. Subsequent scarring of the tissue may make endoscopic resection impossible later on. In that case, surgical removal of the affected segment of the intestine may be necessary, which can often be done endoscopically, that is, minimally invasively, nowadays. It is crucial to perform a complete colonoscopy, examining the entire rectum up to the so-called ileocecal valve, as other adenomas may be found that also need to be completely removed. Therefore, knowledge of the endoscopy findings is essential. Your treating gastroenterologist, who likely performed the examination, will surely advise you on this and provide you with appropriate follow-up appointments. Finally, I would like to note that colon adenomas have nothing to do with a possible reflux disease, as reflux disease affects the lower part of the esophagus. I hope I was able to help you.
Best regards, O. Stephan
