The flat adenoma: Significance and management

Some studies have suggested that flat adenomas have a disproportionate propensity for high-grade dysplasia relative to size, but prospective studies are required to establish the prevalence of high-grade dysplasia. Flat adenomas in the proximal colon, particularly in association with fundic gland polyps of the stomach, should prompt a review of the family history to rule out hereditary flat adenoma syndrome. Flat adenomas may be difficult to identify at endoscopy; insufflation and deflation facilitate identification. The best method for endoscopic removal remains controversial.