Malignant polyps

Abstract

To the Editor:Binmoeller and colleagues1Binmoeller KF Bohnacker S Seifert H et al.Endoscopic excision of “giant” colorectal polyps.Gastrointest Endosc. 1996; 43: 183-188Abstract Full Text Full Text PDF PubMed Scopus (191) Google Scholar have recently reported their experience with endoscopic excision of large colorectal polyps. In their report, the authors state that “coexistent malignancy” was present in 12% of resected polyps. In reality, however, less than 12% of polyps resected in the study were truly “malignant.” By definition, “malignant polyps” contain histologic evidence of malignant cells that have extended beyond the muscularis mucosa and into the submucosa.2Koretz RL. Malignant polyps: are they sheep in wolves' clothing?.Ann Intern Med. 1993; 118: 63-68Crossref PubMed Scopus (59) Google Scholar, 3Volk EE Goldblum JR Petras RE et al.Management and outcome of patients with invasive carcinoma arising in colorectal polyps.Gastroenterology. 1995; 109: 1801-1807Abstract Full Text PDF PubMed Scopus (197) Google Scholar, 4Cooper HS Deppisch LM Gourley WK et al.Endoscopically removed malignant colorectal polyps: clinicopathologic correlations.Gastroenterology. 1995; 108: 1657-1665Abstract Full Text PDF PubMed Scopus (231) Google Scholar, 5Jass JR. Malignant colorectal polyps.Gastroenterology. 1995; 109: 2034-2035Abstract Full Text PDF PubMed Scopus (29) Google Scholar In the study under discussion, the authors incorrectly considered polyps with evidence of carcinoma in situ as being malignant polyps. Polyps exhibiting carcinoma in situ lack evidence of spread into the submucosa and by definition cannot be considered malignant. Investigations employing endoscopic excision of colorectal polyps should use accepted and standardized definitions to avoid possible confusion in interpretation of results. To the Editor:Binmoeller and colleagues1Binmoeller KF Bohnacker S Seifert H et al.Endoscopic excision of “giant” colorectal polyps.Gastrointest Endosc. 1996; 43: 183-188Abstract Full Text Full Text PDF PubMed Scopus (191) Google Scholar have recently reported their experience with endoscopic excision of large colorectal polyps. In their report, the authors state that “coexistent malignancy” was present in 12% of resected polyps. In reality, however, less than 12% of polyps resected in the study were truly “malignant.” By definition, “malignant polyps” contain histologic evidence of malignant cells that have extended beyond the muscularis mucosa and into the submucosa.2Koretz RL. Malignant polyps: are they sheep in wolves' clothing?.Ann Intern Med. 1993; 118: 63-68Crossref PubMed Scopus (59) Google Scholar, 3Volk EE Goldblum JR Petras RE et al.Management and outcome of patients with invasive carcinoma arising in colorectal polyps.Gastroenterology. 1995; 109: 1801-1807Abstract Full Text PDF PubMed Scopus (197) Google Scholar, 4Cooper HS Deppisch LM Gourley WK et al.Endoscopically removed malignant colorectal polyps: clinicopathologic correlations.Gastroenterology. 1995; 108: 1657-1665Abstract Full Text PDF PubMed Scopus (231) Google Scholar, 5Jass JR. Malignant colorectal polyps.Gastroenterology. 1995; 109: 2034-2035Abstract Full Text PDF PubMed Scopus (29) Google Scholar In the study under discussion, the authors incorrectly considered polyps with evidence of carcinoma in situ as being malignant polyps. Polyps exhibiting carcinoma in situ lack evidence of spread into the submucosa and by definition cannot be considered malignant. Investigations employing endoscopic excision of colorectal polyps should use accepted and standardized definitions to avoid possible confusion in interpretation of results. Binmoeller and colleagues1Binmoeller KF Bohnacker S Seifert H et al.Endoscopic excision of “giant” colorectal polyps.Gastrointest Endosc. 1996; 43: 183-188Abstract Full Text Full Text PDF PubMed Scopus (191) Google Scholar have recently reported their experience with endoscopic excision of large colorectal polyps. In their report, the authors state that “coexistent malignancy” was present in 12% of resected polyps. In reality, however, less than 12% of polyps resected in the study were truly “malignant.” By definition, “malignant polyps” contain histologic evidence of malignant cells that have extended beyond the muscularis mucosa and into the submucosa.2Koretz RL. Malignant polyps: are they sheep in wolves' clothing?.Ann Intern Med. 1993; 118: 63-68Crossref PubMed Scopus (59) Google Scholar, 3Volk EE Goldblum JR Petras RE et al.Management and outcome of patients with invasive carcinoma arising in colorectal polyps.Gastroenterology. 1995; 109: 1801-1807Abstract Full Text PDF PubMed Scopus (197) Google Scholar, 4Cooper HS Deppisch LM Gourley WK et al.Endoscopically removed malignant colorectal polyps: clinicopathologic correlations.Gastroenterology. 1995; 108: 1657-1665Abstract Full Text PDF PubMed Scopus (231) Google Scholar, 5Jass JR. Malignant colorectal polyps.Gastroenterology. 1995; 109: 2034-2035Abstract Full Text PDF PubMed Scopus (29) Google Scholar In the study under discussion, the authors incorrectly considered polyps with evidence of carcinoma in situ as being malignant polyps. Polyps exhibiting carcinoma in situ lack evidence of spread into the submucosa and by definition cannot be considered malignant. Investigations employing endoscopic excision of colorectal polyps should use accepted and standardized definitions to avoid possible confusion in interpretation of results.