title: The malignant colonic polyp Review of biological, clinical parameters and treatment.
abstract: We know the significance of adenomas about the risk of neoplastic transformation defined as adenoma-carcinoma sequence. Although the majority of adenomas removed are small, it is well recognized that the risk of malignant transformation increases with an increased adenoma size. The term "malignant polyp" refers to an adenoma that macroscopically appears benign, but in which there is an invasion of malignant neoplastic cells within the submucosa through the muscularis mucosae. Malignant Polyps are substantially adenocarcinomas at an early stage; it is estimated that they represent the 0.75-5.6% of all adenomas removed during endoscopic exams. The management of a malignant polyp, diagnosed after an endoscopic removal, is complicated because the presence of residual malignant cells is a possibility. Also the presence of regional lymph nodes metastasis is different in literature and related to different prognostic factors. In this review we will analyze the incidence, the most appropriate methods of diagnosis, the biological parameters that characterize the various classes of risk of malignant polyps, in order to choice a correct treatment. The goal should be the improvement of the survival rate, decreasing the likelihood of residual disease evaluating the risk of overtreatment.
  
  
  BACKGROUND
  Adenoma, Adenoma-carcinoma, "Malignant polyp".
authors.forename: Paolo
authors.initials: P
authors.lastname: Del Rio
authors.forename: Federico
authors.initials: F
authors.lastname: Cozzani
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Viani
authors.forename: Piercosimo
authors.initials: P
authors.lastname: Nisi
authors.forename: Matteo
authors.initials: M
authors.lastname: Rossini
authors.forename: Mario
authors.initials: M
authors.lastname: Sianesi
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D018253:Adenoma, Villous / Q000473:pathology / Q000601:surgery; D018256:Adenomatous Polyps / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D003111:Colonic Polyps / Q000145:classification / Q000473:pathology* / Q000601:surgery; D003113:Colonoscopy; D019468:Disease Management; D006801:Humans; D006965:Hyperplasia; D007413:Intestinal Mucosa / Q000473:pathology; D008207:Lymphatic Metastasis; D000072662:Margins of Excision; D009130:Muscle, Smooth / Q000473:pathology; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D012306:Risk; D047368:Tumor Burden