Intestinal polyps that can potentially grow into cancer

Ans. a (Adenomatous polyp) (Ref. Bailey and Love surgery 24th/pg. 1177).# Not pre-malignant - Hyperplastic polyp.COLONIC POLYPSAdenomatous polyp:# Benign epithelial neoplasm# They are pre-malignant and risk of malignancy increases with size# Malignancy more common in villous rather than tubular lesions# Most adenomas are asymptomatic# 10% of population over 45 years have adenomatous polyps# If do become symptomatic usually present with bleeding, mucous discharge or prolapse# Villous adenomas may produce hypokalemia but this is rare# Diagnosis is often by sigmoidoscopy or colonoscopy# Full colonoscopy essential to exclude other lesions# Treatment is by transanal excision or colonoscopic snaring# Patients require regular colonoscopic surveillanceJuvenile Polyp# Commonest form of polyp in children# Can occur throughout large bowel but are most common in the rectum# Usually present before 12 years# Present with prolapsing lump or rectal bleeding# Not pre-malignant# Treated by local endoscopic resection# Juvenile polyposis can be premalignant.Peutz-Jeghers syndrome# Rare familial disorder# Circumoral pigmentation and intestinal polyps# Polyps found throughout gut but most common in the small intestine# Presents in childhood with bleeding, anaemia or intussusception# PJS Polyps per say are not malignant.Metaplastic polyp:# Small plaques approximately 2 mm in diameter# Pathogenesis unknown