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National Program of Cancer Registries - page 12 / 93

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Malignancies in a Polyp

  • (3)

    Invades head of polyp

  • (2)

    In situ in a polyp

(1) Invades submucosa

  • (4)

    Invades stalk of polyp

  • (5)

    In lamina propria

    • (6)

      In muscularis

mucosa

Graphic from CS Steering Committee Training Materials

The adenomatous polyp or polypoid adenoma is the precursor to adenocarcinoma of the colon. 85% of adenocarcinomas of the colon evolve from adenomatous polyps. The majority of adenomatous polyps are benign, but they may transpose to malignancy. Those malignancies may be in situ (non-invasive) or invasive. The diagram shows examples of polypoid malignancies.

Going clockwise starting in the lower left corner, the first malignancy in the polyp invades the submucosa. The second malignancy is non-invasive (in situ) in a polyp. The third malignancy is invasive and invades the head of the polyp. The fourth malignancy is also invasive and invades the stalk of the polyp. The fifth lesion does not go beyond the lamina propria of the mucosa. The sixth malignancy invades the muscularis mucosa but does not go into the submucosa.

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