Sessile Serrated Polyp / Adenoma
Clinical
- Primarily occur in adults
- Age range of patients with SSA and foci of dysplasia or carcinoma 54-87 years
- May be the principal source of sporadic MSI high adenocarcinomas
- They share DNA hypermethylation and BRAF mutations
- Complete removal is recommended if possible, especially for:
- Lesions >1 cm
- Lesions with focal dysplasia
- Following resection, patients are typically followed up in a similar manner as those with a usual type tubular adenoma
(Huang 2011, Snover 2011)
| Number and Size |
Surveillance Interval |
| <3 polyps, all <1 cm |
5 years |
| ≥3 polyps or any one ≥1 cm |
3 years |
- If dysplasia is present, polyp must be completely removed
- May require both colonoscopic and pathologic evaluation
- May require immediate repeat endoscopy to assess adequacy
- Surveillance colonoscopy in 1 to 3 years
- Above intervals may be shortened in cases with family history or arising < age 50
- See serrated adenomatous polyposis if numerous
