Treatment of Colon Polyp: Flat and Depressed Neoplastic Colorectal Lesions, Including Lesions Suspected of Carcinoma

Flat and depressed neoplastic colorectal lesions represent a specific morphological subgroup of colon polyps that requires a distinct management approach. This includes lesions in which carcinoma is suspected on colonoscopy — a scenario where size alone does not determine the need for intervention.

Clinical Scenario

Flat and depressed neoplastic colorectal lesion identified on colonoscopy, including lesions where carcinoma is suspected. Even small lesions of this morphological type fall within the scope of active endoscopic management.

Treatment Approach (partial overview)

Endoscopic resection is the indicated strategy for this lesion type. A particular endoscopic technique is preferred across lesion sizes. The complete protocol — including technique selection, procedural criteria, and post-procedure management — is available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1007/s00535-021-01776-1

Endoscopic resection should be performed for flat and depressed neoplastic lesions even if B 5 mm in size (recommendation strong [agreement rate 100%], level of evidence D).
On the other hand, flat and depressed neoplastic lesions and those suspected of being carcinoma on colonoscopy are preferably treated by EMR regardless of size [23].

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