Adenomas in Chronic Ulcerative Colitis: Colectomy or Continued Surveillance?

In chronic ulcerative colitis, surveillance colonoscopy is used to identify patients at risk for cancer. A well-accepted indication for colectomy is the DALM (dysplasia-associated lesion or mass). However, patients with chronic ulcerative colitis also develop sporadic adenomas based on their age rather than the cancer potential of the colitis. These sporadic adenomas are mass lesions that by definition contain dysplasia, and thus there is inherent difficulty in differentiating them from classic DALMs. Two groups recently reported their experience following patients with chronic ulcerative colitis who appeared to have sporadic adenomas based on typical endoscopic appearance and absence of dysplasia in flat mucosa.

The first study described 24…