Huge Mass Of The Descending Colon (8 of 25)

It is important to remember that most polyps identified at colonoscopy will never cause the patient harm. In most cases the adenoma-carcinoma sequence progresses slowly. The endoscopist should therefore always consider the likely natural history of the lesion, the age and co-morbidity of the patient and the risks of the intervention, prior to the procedure. However, the malignant potential of individual polyps is never known and even small/diminutive polyps can occasionally harbour cancer. It is therefore advisable that all polyps (even diminutive rectal polyps) should be removed unless they are obviously non-neoplastic. Polypectomy should not be attempted on a lesion that does not lift following submucosal saline injection. Non-pedunculated polyps with overt signs of invasion are also best tattooed and biopsied. Although some specialists are resecting larger and larger mucosal lesions, the endoscopist should only consider removing lesions within their level of experience.