This patient with ulcerative colitis has developed a polyp in the transverse colon. The lesion has now been sent for an endoscopic resection.
WHAT WOULD YOU DO?
You are creating a problem of your own making!
Some would say; "if you can remove the lesion in that colitic colon, then 'do it'! The problem is that nothing may appear "irresectable" giving plenty of time, determination and poor judgement.
Many studies looking at outcomes of polypectomy in UC, excluded polyps >1-2cm or flat polyps. Other studies have included polyps arising outside of the colitic field or only have a short follow up period of a few years.
Actually, most are coming to believe that when dysplasia develops in the colitic colon, it's not a 'random' case of bad luck. It can be the result of a long process of progressive DNA damage! At some stage we will be able to have a look at the state of the stem cell DNA in patients with conditions such as Barrett's, Colitis and atrophic gastritis. I think that we are in for a surprise !
In addition, did you spot the small focus of invasive cancer in the 2-3 O'clock position? Surprisingly, this was only T1 disease!