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A sessile serrated lesion (SSL) is a premalignant flat (or sessile) lesion of the colon, predominantly seen in the cecum and ascending colon. SSLs are thought to lead to colorectal cancer through the (alternate) serrated pathway. [1] [2] This differs from most colorectal cancer, which arises from mutations starting with inactivation of the APC ...
Sessile serrated adenoma seen under microscopy with H&E stain. Serrated polyposis syndrome often does not cause symptoms. The risk of colon cancer is between 25 and 40%. [8] Sessile serrated polyps, as seen during endoscopy or colonoscopy, are flat (rather than raised) and are easily overlooked.
A sessile serrated adenoma is suspected in case of any of the following: [4] Size ≥0.5 cm; Location in right colon; If both are present, it is almost always an SSA. Other features causing a suspicion for sessile serrated adenoma are: [4] Dilation of crypts; Branching of crypts; Horizontal glands at the base; Mature mucinous cells at the base ...
Micrograph of a sessile serrated adenoma. H&E stain. Sessile serrated adenomas are characterized by (1) basal dilation of the crypts, (2) basal crypt serration, (3) crypts that run horizontal to the basement membrane (horizontal crypts), and (4) crypt branching. The most common of these features is basal dilation of the crypts.
As is evident from their name, sessile serrated and traditional serrated adenomas (TSAs) have a serrated appearance and can be difficult to distinguish microscopically from hyperplastic polyps. [18] Making this distinction is important, however, since SSAs and TSAs have the potential to become cancers, [19] while hyperplastic polyps do not. [18]
The risks of progression to colorectal cancer increase if the polyp is larger than 1 cm and contains a higher percentage of villous component. Also, the shape of the polyps is related to the risk of progression into carcinoma. Polyps that are pedunculated (with a stalk) are usually less dangerous than sessile polyps (flat polyps). Sessile ...
Hereditary nonpolyposis colorectal cancer (HNPCC) is a hereditary predisposition to colon cancer.. HNPCC includes (and was once synonymous with) [1] Lynch syndrome, an autosomal dominant genetic condition that is associated with a high risk of colon cancer, endometrial cancer (second most common), ovary, stomach, small intestine, hepatobiliary tract, upper urinary tract, brain, and skin. [2]
The extracolonic tumors may include osteomas of the skull, thyroid cancer, epidermoid cysts, fibromas, [4] as well as the occurrence of desmoid tumors in approximately 15% of affected individuals. Desmoid tumors are fibrous tumors that usually occur in the tissue covering the intestines and may be provoked by surgery to remove the colon.