Superficial Serrated Adenoma: A Rare Case of Sigmoid Polyp With Malignant Potential.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2024-12-24 eCollection Date: 2024-12-01 DOI:10.7759/cureus.76305
Yu-Cong Chen, Yung-Ning Huang, Yang-Bor Lu
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Abstract

We present the case of a 68-year-old woman who underwent complete endoscopic resection of a superficial serrated adenoma (SuSA). Due to its rarity and limited case reports, SuSA is often misdiagnosed as a hyperplastic lesion without malignant potential, leading to missed diagnoses. A polypoid lesion was identified in the sigmoid colon during the initial endoscopic evaluation, where it was initially classified as a sessile serrated lesion (SSL). The subsequent endoscopic evaluation, using crystal violet staining, revealed a type IIIL pit pattern. Endoscopic mucosal resection (EMR) was performed, and histopathological analysis confirmed serrated glandular hyperplasia with mild atypia. Immunohistochemical staining showed cytokeratin 20 (CK20) expression predominantly in the upper layer, while Ki-67 and cellular myelocytomatosis oncogene (c-MYC) were distributed in the basal and intermediate layers. Beta-catenin positivity was observed in the cytoplasm of some nuclei, confirming the diagnosis of SuSA. This case underscores the importance of timely recognition and management of SuSA to prevent progression to more severe conditions.

表浅锯齿状腺瘤:一罕见的乙状结肠息肉,具恶性潜能。
我们提出的情况下,68岁的妇女谁接受了完整的内镜切除浅锯齿状腺瘤(SuSA)。由于罕见且病例报道有限,SuSA常被误诊为无恶性潜能的增生性病变,导致漏诊。在最初的内镜评估中发现乙状结肠息肉样病变,最初被归类为无柄锯齿状病变(SSL)。随后的内镜评估,使用结晶紫染色,显示了iii型凹坑模式。内镜下粘膜切除术(EMR),组织病理学分析证实锯齿状腺体增生伴轻度异型性。免疫组化染色显示细胞角蛋白20 (CK20)主要在上层表达,Ki-67和细胞髓细胞瘤癌基因(c-MYC)分布在基底层和中间层。部分细胞核细胞质中β -连环蛋白阳性,证实了SuSA的诊断。该病例强调了及时识别和管理SuSA的重要性,以防止进展到更严重的情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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