Pedunculated adenomatous polyp with carcinoma in the tip and metastasis to lymph nodes

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Abstract
A LIVELY CONTROVERSY centers around the behavior of intestinal polyps, especially colonic polyps of the adenomatous type. Some writers regard ali adenomatous polyps as potentially malignant; 4 others believe that they rarely become malignant.S, 8,9 It has been stated that aclenomatous polyps containing cancer and not invading the base of the pedicle or stalk can be cured by adequate locM excision, t, 3 In the extensive and rather selective case material at the Armed Forces Institute of Pathology, Helwig 6 found 2I patients with adenomatous polyps containing invasive carcinoma in the tip. Of 11 adenomatous polyps removed with mesenteric lymph nodes, none had metastasis to lymph nodes. In two of the remaining 10 patients whose polyps were treated by excision only, metastatic adenocarcinoma developed later and apparently originated in the polypoid lesions. It is the purpose of this paper to report an unusual instance of metastasis to lymph nodes from an adenocarcinoma occurring in the tip of a pedunculated adenomatous polyp of the colon in which there was no involvement of the stalk.