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What Do Pre-cancerous Polyp In A Colon Biopsy Indicate?
Question: Hi I am 48 years old and had a colonoscopy due to abdominal pain. The doctor spoke to me and sent me a summary of his findings. They are as follows:
Comments: Spoke with pt. No celiac, microscopic colitis or Crohn's detected. Incidental tubular adenoma was not visualized on video exam. Raises some concern for additional lesions or residual. Options range from repeating exam soon (6-12 months) to performing surveillance in 3-5 years. Given that I cannot be certain all polyp tissue was removed, I favor repeating in 1 year to reassess. She is agreeable.
I have received the biopsy results from your colonoscopy on 05/28/2014. They include the following:
The biopsy of your colon is benign colon tissue, shows no colitis (no inflammation of the lining of the wall of the colon). One of the small biopsies showed a small pre-cancerous polyp. I did not visually see a polyp in this area but some polyps are quite flat and subtle in appearance. Given this surprising finding, I do recommend that we perform a repeat exam in 3 years to make sure no additional subtle polyps are present
My question is should I seek a second opinion? How do I know that I do not have flat polyps (lesions) that he did not see that are pre-cancerous or cancerous. The doctor could not believe that his random biopsy found a adenoma. Very confused and worried!
Comments: Spoke with pt. No celiac, microscopic colitis or Crohn's detected. Incidental tubular adenoma was not visualized on video exam. Raises some concern for additional lesions or residual. Options range from repeating exam soon (6-12 months) to performing surveillance in 3-5 years. Given that I cannot be certain all polyp tissue was removed, I favor repeating in 1 year to reassess. She is agreeable.
I have received the biopsy results from your colonoscopy on 05/28/2014. They include the following:
The biopsy of your colon is benign colon tissue, shows no colitis (no inflammation of the lining of the wall of the colon). One of the small biopsies showed a small pre-cancerous polyp. I did not visually see a polyp in this area but some polyps are quite flat and subtle in appearance. Given this surprising finding, I do recommend that we perform a repeat exam in 3 years to make sure no additional subtle polyps are present
My question is should I seek a second opinion? How do I know that I do not have flat polyps (lesions) that he did not see that are pre-cancerous or cancerous. The doctor could not believe that his random biopsy found a adenoma. Very confused and worried!
Brief Answer:
Schedule another colonoscopy after 6 months...
Detailed Answer:
Hi there,
If no visual polyp was not seen during colonoscopy and if biopsy revealed precancerous polyps (flat), then, I advise to run another colonoscopy after 6 months from the last one you did. This is to evaluate the progress of polyps.
Now, usually, the next follow up is after 1 to 3 years, however, in your case, to my judgment, you should repeat colonoscopy after 6 months and 1 year. If nothing visual is seen, then, can schedule another appointment after 3 years.
For the moment, I do not see any reason why to seek another second opinion. Just continue following up after 6 months. If you want to be at peace, you can seek another opinion although my judgment.
In cases of flat polyps, patients are scheduled for regular follow ups to see the progress of polyps. They cannot be removed at this size.
Hope it answered to your queries!
Let me know if I can assist you further!
Dr.Klerida
Schedule another colonoscopy after 6 months...
Detailed Answer:
Hi there,
If no visual polyp was not seen during colonoscopy and if biopsy revealed precancerous polyps (flat), then, I advise to run another colonoscopy after 6 months from the last one you did. This is to evaluate the progress of polyps.
Now, usually, the next follow up is after 1 to 3 years, however, in your case, to my judgment, you should repeat colonoscopy after 6 months and 1 year. If nothing visual is seen, then, can schedule another appointment after 3 years.
For the moment, I do not see any reason why to seek another second opinion. Just continue following up after 6 months. If you want to be at peace, you can seek another opinion although my judgment.
In cases of flat polyps, patients are scheduled for regular follow ups to see the progress of polyps. They cannot be removed at this size.
Hope it answered to your queries!
Let me know if I can assist you further!
Dr.Klerida
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Klerida, Thank you for your thoughtful response. Flat polyps seem to prevent a huge challenge. I have read many articles about them and it appears that they can be indented or embedded within the colon and have a much greater chance of being malignant and metastasizing . The article below sites a technique called endoscopic mucosal resection, a technique to remove these flat polyps.
http://www.practicalgastro.com/pdf/September12/Coe.pdf
So my questions are: 1. Are you familiar with endoscopic mucosal resection? 2. how do I bring this up to my doctor without insulting him? 3. What type of questions can I ask my current doctor to figure out if he can really detect these type of flat polyps?
Thank you for any more insight into these issues!
Brief Answer:
Kindly upload the biopsy results...
Detailed Answer:
Hi back,
Thank you for following up!
1. Endoscopy is my particular field of interest.
2. You can discuss it further with your doctor and ask him if endoscopic mucosal/submucosal resection is done at his clinic. If yes, can ask for details of this technique, outcomes and precautions.
3. Before going into particular questions, I'd like to have the reports of biopsy and endoscopy, so I can judge myself over the presence of flat polyps in your case.
Looking forward to have the reports in!
Dr.Klerida
Kindly upload the biopsy results...
Detailed Answer:
Hi back,
Thank you for following up!
1. Endoscopy is my particular field of interest.
2. You can discuss it further with your doctor and ask him if endoscopic mucosal/submucosal resection is done at his clinic. If yes, can ask for details of this technique, outcomes and precautions.
3. Before going into particular questions, I'd like to have the reports of biopsy and endoscopy, so I can judge myself over the presence of flat polyps in your case.
Looking forward to have the reports in!
Dr.Klerida
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just asked the dr's office to send me the actual pathology report. I am waiting on this report and will send it on to you when I receive it. Thank you again!
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