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Serrated polyposis: rapid and relentless development of colorectal neoplasia Edelstein DL; Axilbund JE; Hylind LM; Romans K; Griffin CA; Cruz-Correa M; Giardiello FMGut 2013[Mar]; 62 (3): 404-8OBJECTIVE: Serrated (hyperplastic) polyposis (SP) is a rare disorder with multiple colorectal hyperplastic polyps and often sessile serrated adenomas/polyps (SSA/P) or adenomas. Although associated with colorectal cancer, the course of SP is not well described. DESIGN: 44 patients with SP were studied. The results of 146 colonoscopies with median follow-up of 2.0 years (range 0-30) and a median of 1.0 years (range 0.5-6) between surveillance colonoscopies were evaluated. Findings from oesophogastroduodenoscopy examinations were analysed. RESULTS: The mean age at diagnosis of SP was 52.5 +/- 11.9 years (range 22-78). In two pedigrees (5%) another family member had SP. None of 22 patients had gastroduodenal polyps. All patients had additional colorectal polyps at surveillance colonoscopy. SSA/P or adenomas were found in 25 patients (61%) at first colonoscopy and 83% at last colonoscopy. Recurrent SSA/P or adenomas occurred in 68% of patients at surveillance colonoscopy. Three patients had colorectal cancer. Eleven patients (25%) underwent surgery (mean time from diagnosis of SP 2.0 +/- 0.9 years). After surgery all seven surveyed patients developed recurrent polyps in the retained colorectum (4/7 had SSA/P or adenomas). No association was found between colorectal neoplasia and sex, age at diagnosis of SP or initial number of colorectal polyps. CONCLUSIONS: In SP, rapid and unrelenting colorectal neoplasia development continues in the intact colorectum and retained segment after surgery. These findings support the possibility of annual colonoscopic surveillance, consideration for colectomy when SSA/P or adenomas are encountered and frequent postoperative endoscopic surveillance of the retained colorectum.|*Cell Transformation, Neoplastic[MESH]|*Precancerous Conditions[MESH]|Adenoma/*diagnosis/genetics/surgery[MESH]|Adult[MESH]|Aged[MESH]|Cohort Studies[MESH]|Colonic Polyps/*pathology/surgery[MESH]|Colonoscopy[MESH]|Colorectal Neoplasms/*diagnosis/genetics/surgery[MESH]|Endoscopy, Gastrointestinal[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Pedigree[MESH]|Recurrence[MESH]|Registries[MESH]|Retrospective Studies[MESH]|Young Adult[MESH] |
