A patient on colonoscopy was found to have tubular adenoma which was removed. The pathology report suggested that the adenoma was found to extend up to the muscularis mucosae. The management now includes

(C) Observation # Treatment.:> In case of small tumours without invasive malignancy above the peritoneal reflexion, colonoscopic removal by cautery snare is justified.> All polypoid lesions greater than 1 cm diameter should be removed totally and submitted for histologic examination.> Large tumours with invasive malignancy located above 7.5 cm from the Dentate line, anterior resection is indicated.> When the similar lesion lies less than 7.5 cm above the dentate combined abdominoperineal resection should be performed.> When invasive cancer is not demonstrable on biopsy, the lesion is completely excised after wide dilation or division of the anal sphincter.> The entire specimen is now examined histologically.> If invasive malignancy is not detected, no further treatment is necessary.> If invasive malignancy is detected, immediate abdominoperineal resection should be carried out.> It is always advisable to do follow-up proctoscopy at regular intervals, as recurrence is common even though the lesion is histologically benign.