Malignant Potential of Adenomas of Colon and Rectum

Enterline, Horatio T.; Evans, George W.; Mercado-Lugo, Roberto; Miller, Leonard D.; Fitts, William T.

doi:10.1001/jama.1962.03050050012003

Cited by 148 publications

(14 citation statements)

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“…As the size of adenomas increases, so does the grade of dysplasia, in agreement with previous studies [4,22,24]. Size is the most simple and practical indicator and is closely related to grade of dysplasia.…”

Section: Size and Grade Of Dysplasiasupporting

confidence: 91%

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Contribution of the pathologist to the radiology and management of colorectal polyps

Morson

Konishi

1982

Gastrointest Radiol

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Section: Size and Grade Of Dysplasiasupporting

confidence: 91%

“…It has been stated that villous adenomas are located almost exclusively in the rectum [22,23]. In contrast, our study has shown that both tubulovillous and villous adenomas are more widely distributed with only a slightly higher incidence in the rectum and in the sigmoid colon.…”

Section: Histologic Typescontrasting

confidence: 85%

Contribution of the pathologist to the radiology and management of colorectal polyps

Morson

Konishi

1982

Gastrointest Radiol

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“…In addition, because this study included prevalent, rather than incident, polyps, it is not possible to discriminate between factors affecting the risk and the duration of polyps. However, factors that affect duration may also be important, because larger polyps, which are probably of a longer duration, may be more likely to undergo malignant transformation (Enterline et al, 1962;Hoff et al, 1987). Despite the potential limitations of the study, however, the response rates were high for both the case and control groups, and with nearly 500 case-control pairs, this is among the largest studies of risk factors for colorectal polyps.…”

Section: Discussionmentioning

confidence: 85%

“…Because adenomatous polyps are likely precursors of colorectal carcinoma (Enterline et al 1962;Stryker et al, 1987;Jass, 1989;Pollock and Quirke, 1991), research has focused on risk factors for colorectal adenomas in recent years. Many studies have reported protective associations of physical activity with risk of colorectal adenomas (Kato et al, 1990; Kono et al, 1991;Benito et al, 1993;Giovannucci et al, 1996), and others have demonstrated more modest protective associations (Little et al, 1993;Giovannucci et al, 1995;Sandler et al, 1995).…”

mentioning

confidence: 99%

Recent and past physical activity and prevalence of colorectal adenomas

Enger

Longnecker²,

Lee³

et al. 1997

Br J Cancer

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Summary Epidemiological evidence has generally supported a protective association of physical activity with large-bowel adenomas, but whether the protective effects are restricted to recent or past activity is uncertain. We determined whether recent and past recreational or total daily activity was associated with prevalence of colorectal adenomas among male and female members of a prepaid health plan in Los Angeles who underwent sigmoidoscopy (n = 488 matched pairs). Participants, aged 50-74 years, completed a 126-item semiquantitative food frequency questionnaire and were also interviewed regarding non-dietary risk factors in 1991-93. In the univariate analysis, all measures of recent recreational physical activity were associated with reduced prevalence of polyps. After adjustment for body mass index, smoking status, daily servings of fruit and vegetables, use of non-steroidal anti-inflammatory agents and intakes of calories, saturated fat and alcohol, the associations were weakened. For subjects engaging in high-intensity activities compared with subjects not engaging in vigorous activities, the multivariate odds ratio (OR) for recent recreational activity was 0.7 [95 % confidence interval (Cl) 0.4-1.1, trend P = 0.08]. Past recreational activity and past or recent total daily activity were not associated with prevalence of adenomas. These results support a modest association of recent recreational physical activity with prevalence of colorectal adenomas.Keywords: colorectal adenoma; physical activity; case-control study Results of epidemiological studies over the past two decades have fairly consistently supported a protective association of physical activity with cancer of the large bowel (Lee et al, 1991;Dosemeci et al, 1993;Fraser and Pearce, 1993;Potter et al, 1993;Longnecker et al, 1995). Because adenomatous polyps are likely precursors of colorectal carcinoma (Enterline et al 1962; Stryker et al, 1987;Jass, 1989;Pollock and Quirke, 1991), research has focused on risk factors for colorectal adenomas in recent years. Many studies have reported protective associations of physical activity with risk of colorectal adenomas (Kato et al, 1990;Kono et al, 1991;Benito et al, 1993;Giovannucci et al, 1996), and others have demonstrated more modest protective associations (Little et al, 1993;Giovannucci et al, 1995;Sandler et al, 1995). Whether the protective effects are greater among certain subgroups of the population or are restricted to recent or past activity is uncertain.In the present study, extensive data on diet, smoking and other lifestyle factors were collected and controlled in the analyses of several indicators of recent and past physical activity with colorectal adenomas among men and women who underwent sigmoidoscopy in Los Angeles. METHODSSubjects of either sex were eligible for the study if they underwent sigmoidoscopy at either of two southern California Kaiser Permanente Medical Centers (Bellflower and Sunset) from 1 January 1991 to 25 August 1993 and fulfilled the following criteria: age 50-74...

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“…The rate of malignant transformation in the 46 villous adenomas of the duodenum reported to date was about 36%, somewhat less than the rate in the colon and rectum (55%) reported by Ente~line et al [8], but still definitely establishing the premalignant nature of villous gastrointestinal tumors regardless of location. …”

Section: Discussionmentioning

confidence: 58%

Adenocarcinoma of the duodenum arising in a villous adenoma

Hessler

Braunstein

1977

Gastrointest Radiol

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Abstract. Duodenal villous adenomas are premalignant lesions. Prior to malignant transformation, their appearance on upper gastrointestinal examination is often characteristic. Following malignant change, the final diagnosis frequently requires tissue.Key words: Duodenum -Villous adenoma -Malignant potential -Adenocarcinoma.Since Golden described a villous adenoma of the duodenum in 1928 [1], fewer than 50 cases have been described in the world literature [2,3,4]. Of these about a quarter had undergone malignant transformation into invasive carcinoma. The present case illustrates the clinical and radiologic aspects of adenocarcinoma arising in a villous adenoma of the duodenum in hopes of facilitating its earlier diagnosis. Case ReportA 70-year-olcl woman was admitted to Danbury Hospital in June, 1974, with a 16-year history of gradually worsening postprandial right upper quadrant pain, nausea, and vomiting suggesting partial gastric outlet obstruction. A suboptimal radiologic examination of the upper gastrointestinal tract in 1956 had shown a non-specific irregularity of the medial aspect of the supra-ampullary duodenum, but these findings were not pursued, and the patient had improved after learning to eat frequent, small meals. Repeated subpotential upper gastrointestinal examinations in 1970 and 1973 showed no change in the duodenal irregularity. In March, 1974, the patient's obstructive symptoms worsened, and she developed anemia and weight loss. At this time upper gastrointestinal examination demonstrated a polypoid tumor partially obstructing the supra-ampullary duodenum in the same area as the previously demonstrated duodenal irregularity. The patient refused treatment and was placed on a liquid diet with fair results. In June, 1974, her obstructive Physical examination showed right upper quadrant tenderness and a palpable mass. There was a mild microcytic anemia, but electrolyte and liver function studies were normal. Gastroscopy was unsuccessful. Reexamination of the upper gastrointestinal tract redemonstrated the tumor (Figs. 1 and 2), and the patient was operated upon. A polypoid villous adenoma was found arising from the medial duodenal wall above the ampulla of Vater. The upper portion had undergone malignant transformation and had invaded the head of the pancreas. Two of eight peripancreatic lymph nodes were involved, but the liver was free of tumor. A pancreaticoduodenectomy was performed, but the patient developed a pancreaticocutaneous fistula and an epigastric abscess and died in septic shock on the 20th postoperative day.

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Malignant Potential of Adenomas of Colon and Rectum

Abstract: A few inflammatory polyps or retention polyps were found that had been originally diagnosed as adenomatous polyp, and these were excluded.

Cited by 148 publications

References 1 publication

Contribution of the pathologist to the radiology and management of colorectal polyps

Contribution of the pathologist to the radiology and management of colorectal polyps

Recent and past physical activity and prevalence of colorectal adenomas

Adenocarcinoma of the duodenum arising in a villous adenoma

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