How are adenomatous appearing polyps managed in patients with UC and Crohn’s disease?
- Adenomatous-appearing polyps should be completely removed by polypectomy, and biopsy specimens should be obtained from the adjacent flat mucosa to determine the presence of dysplasia.
- If no dysplasia or inflammation is found in the surrounding mucosa, then this can be managed as a sporadic adenomatous polyp.
- Colectomy is indicated if dysplasia is identified in an area of active inflammation, also known as dysplasia-associated lesion or mass, and there is evidence of dysplasia in the adjacent mucosa.
- Repeat colonoscopy in 3 to 6 months and close follow-up are warranted when indefinite dysplasia is detected.
- Mucosal tattooing often assists in identifying the area in question on subsequent endoscopies.