The cancer risk of a tubular adenoma is controversial, but strong evidence suggests that it can become malignant. Risk of malignancy is related to size; a 1.5-cm tubular adenoma has a 2% risk. As its size increases, its glands become villous. When > 50% of its glands are villous, it is called a villoglandular polyp; its malignancy potential is still that of a tubular adenoma. When > 80 % of the glands are villous, the polyp is called a villous adenoma , which becomes malignant in about 35% of cases. A villous adenoma has a greater risk of malignancy than a tubular adenoma of the same size.
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