Abstract
BackgroundColorectal juvenile polyps are rare and usually considered benign in adults. Carcinogenesis or neoplastic changes are rarely mentioned in the literature. We aimed to systematically evaluate the characteristics and potential malignancy of colorectal juvenile polyps in adults.MethodsWe retrospectively reviewed the medical records of 103 adults diagnosed with colorectal juvenile polyps from 9/2007 to 5/2020 in our hospital. The characteristics, endoscopic findings, occurrence of intraepithelial neoplasia, carcinogenesis and diagnostic value of chicken skin mucosa (CSM) were analyzed.ResultsThe average age of patients with juvenile polyps was 43.2 years (range, 19 to 78). A total of 101 patients (101/103, 98.1%) had a single juvenile polyp, while two had multiple polyps (107 polyps in total). Polyp sizes ranged from 0.5 to 5 cm. One (1/107, 0.9%) juvenile polyp was cancerous, and 7 (7/107, 6.5%) developed low-grade intraepithelial neoplasia. Neoplasia or cancerization was not associated with the number of polyps. A 27-year-old female had a polyp with well-differentiated adenocarcinoma in the mucosa that was 2 cm in the sigmoid colon with erosion on the surface. According to immunohistochemistry, the Ki-67 was approximately 80%. P53 was mutated with diffuse and strongly positive expression. CSM was observed beside 17 polyps, which were all located in the rectum and sigmoid colon; one polyp had low-grade intraepithelial neoplasia.ConclusionsColorectal juvenile polyps in adults have neoplastic potential. Neither neoplasia nor carcinogenesis was associated with the number of polyps. CSM was not a tumorigenesis marker in colorectal juvenile polyps in the distant colorectum. Colorectal juvenile polyps in adult may go through a ‘low-grade intraepithelial neoplasia to high-grade intraepithelial neoplasia to carcinoma’ path and should be treated and regularly followed up as adenomas.
Colonic Chicken Skin Mucosa Surrounding Colon Polyps Is an Endoscopic Predictive Marker for Colonic Neoplastic Polyps
