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.