Microscopic pathology image showing a tubular adenoma of colon on a colonoscopy.
What are the other Names for this Condition? (Also known as/Synonyms)
- Adenomatous Polyp of Colon with Tubular Features
- Colonic Tubular Adenoma
- Dysplastic Polyp of Colon with Tubular Features
What is Tubular Adenoma of the Colon? (Definition/Background Information)
- Tubular Adenoma of the Colon is the presence of a type of adenoma (tumor) in the large intestine. If these tumors remain untreated, they can develop into colon or rectal cancer
- Tubular adenomas are therefore considered “pre-malignant” tumors; meaning that these tumors may turn malignant with time
- Most of these tumors are first noticed during a screening colonoscopy; a procedure that live-images the interior lining of the colon. In most cases, these tumors are less than 1 cm in size
- If Tubular Adenomas of the Colon are detected early enough, they can be removed and the risk of developing into a cancer is low. If, however, they have time to proliferate and grow, the risk for cancer is quite high
- A complete removal of Colon Tubular Adenoma can result in a cure, and the outcomes are good
Who gets Tubular Adenoma of the Colon? (Age and Sex Distribution)
- Tubular Adenoma of the Colon typically occurs in middle-age to elderly individuals; although, most affected individuals are aged 60 years and over
- In rare cases, younger patients can also develop Colon Tubular Adenomas. This occurs usually due to a genetic mutation or it may be an inherited condition, such as familial adenomatous polyposis (FAP) or inflammatory bowel disease (IBD)
- Both males and females are known to develop these tumors
What are the Risk Factors for Tubular Adenoma of the Colon? (Predisposing Factors)
Common risk factors of Tubular Adenoma of the Colon include:
- Elderly individuals
- Predisposing genetic conditions, like familial adenomatous polyposis (FAP) or inflammatory bowel disease (IBD)
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Tubular Adenoma of the Colon? (Etiology)
- Tubular Adenoma of the Colon is caused by genetic mutations that results in dysplasia
- Dysplasia is the phenomena of disordered growth of the epithelial lining of the colon. Genetic mutations lead to cell growths at abnormally high rates. This causes the cells to grow abnormally, forming the tumors characteristic of a Tubular Adenoma
- The genetic mutations can be either inherited, or caused by exposure to various environmental factors
- Inherited genetic mutations include those that result from familial adenomatous polyposis (FAP)
- Environmental factors that cause genetic mutations may include radiation, harmful chemicals in the air, etc.
What are the Signs and Symptoms of Tubular Adenoma of the Colon?
In rare cases, the signs and symptoms of Tubular Adenoma of the Colon may include:
- Tumor in the colon causing obstructions (if the tumors are large)
- Bleeding from the anus, mucus mixed with stools; both in rare cases
- Rarely, diarrhea or constipation
Most individuals with Tubular Adenoma of the Colon do not show any signs and symptoms. Typically, individuals do not notice that they have a tubular adenoma, until these are visualized during a screening colonoscopy.
How is Tubular Adenoma of the Colon Diagnosed?
A diagnosis of Tubular Adenoma of the Colon may include:
- Physical exam with evaluation of medical history
- Typically, Tubular Adenomas are first diagnosed, during a colonoscopy screening:
- During this procedure, a thin, flexible tube (called a colonoscope) with a video camera attached to it, is inserted into the body to view the colon and rectum
- If Tubular Adenoma is present, a projection will appear on the screen that originates from the epithelial lining of the colon
- During the colonoscopy, the tumor is removed and submitted to a pathologist for examination
- A diagnosis of Tubular Adenoma of the Colon can be made by studying the tumor under a microscope
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Tubular Adenoma of the Colon?
Complications may arise, if Colon Tubular Adenomas are left untreated.
- If the tumor grows too large, it can become cancerous and can develop into a colon or rectal cancer
- This is a life-threatening condition, if not properly diagnosed and treated. However, this process of a tubular adenoma becoming a cancer may take many years
How is Tubular Adenoma of the Colon Treated?
Treatment measures for Tubular Adenoma of the Colon:
- Tubular Adenomas are treated immediately, once they have been discovered, through the screening colonoscopy. The gastroenterologist will remove the tumor via a polypectomy, or ablate the tumor using heat
- If residual tumor remains in the colon after removal, you may need to undergo another colonoscopy, in order to completely remove the growth
- If the tumor has grown too large to be removed via a polypectomy, a surgery may be required to remove a part of the colon. This is called a segmental colectomy. This involves incising the abdomen so that the colon can be reached
How can Tubular Adenoma of the Colon be Prevented?
Currently, there are no known preventative measures against Tubular Adenoma of the Colon.
- It is important to undergo routine colonoscopy screenings as you get older, to ensure that no tumors or polyps develop
- Precautions may also be taken against environmental harms that could cause tubular adenoma. It is helpful to limit one’s exposure to environmental toxins and radiation
What is the Prognosis of Tubular Adenoma of the Colon? (Outcomes/Resolutions)
- With prompt diagnosis and removal of the tumor, Tubular Adenoma of the Colon does not develop into cancer; most individuals are able to resume their normal lives
- If, however, the tumor is not removed quickly and is given time to grow, it can potentially become cancerous. A colon or rectal cancer can develop, as a result of tubular adenoma and this can become life-threatening
Additional and Relevant Useful Information for Tubular Adenoma of the Colon:
Common histological characteristics of the tumor, when observed under a microscope include:
- Polypoid colonic mucosa with superimposed dysplasia (disordered growth of the mucosa layer); this is characterized by the enlargement and elongation of the epithelial cell nuclei
- Loss of goblet cells; abnormally low number of goblet cells
What are some Useful Resources for Additional Information?
American Cancer Society (ACS)
1599 Clifton Road, NE Atlanta, GA 30329-4251
Toll-Free: (800) 227-2345
TTY: (866) 228-4327
References and Information Sources used for the Article:
http://www.ssat.com/cgi-bin/polyps.cgi (accessed on 08/03/2014)
http://www.gihealth.com/html/education/colonpolyps.html (accessed on 08/03/2014)
http://www.ccalliance.org/colorectal_cancer/diagnosis.html (accessed on 08/03/2014)
http://www2.mdanderson.org/app/pe/index.cfm?pageName=opendoc&docid=3235 (accessed on 08/03/2014)
http://www.cancer.org/treatment/understandingyourdiagnosis/understandingyourpathologyreport/colonpathology/colon-polyps-sessile-or-traditional-serrated-adenomas (accessed on 08/03/2014)
Helpful Peer-Reviewed Medical Articles:
Altomare, J. F., & Komar, M. J. (2006). A tubular adenoma arising in a colonic interposition. J Clin Gastroenterol, 40(8), 765-766.
Ferreira, R., Torres, J., Raposo, J., Duarte, M. B., Pereira, M. J., Carvalheiro, J., . . . Campos, M. J. (2011). Multifocal colonic mucosa-associated lymphoid tissue lymphoma with synchronous tubular adenoma: a coincidental association? Int J Colorectal Dis, 26(9), 1221-1222. doi: 10.1007/s00384-010-1102-7
Matthiessen, M. W., Pedersen, G., Albrektsen, T., Adamsen, S., Fleckner, J., & Brynskov, J. (2005). Peroxisome proliferator-activated receptor expression and activation in normal human colonic epithelial cells and tubular adenomas. Scand J Gastroenterol, 40(2), 198-205. doi: 10.1080/00365520410009573
Sztarkier, I., Levy, I., Walfisch, S., Delgado, J., & Benharroch, D. (2009). Mantle cell lymphoma in a tubular adenoma: unusual presentation with synchronous colonic carcinoma. Ann Diagn Pathol, 13(1), 47-49. doi: 10.1016/j.anndiagpath.2007.05.017
White, V., Shaw, A. G., Tierney, G. M., Lund, J. N., & Semeraro, D. (2008). Osseous metaplasia in an ulcerating tubular adenoma of the colon: a case report. J Med Case Rep, 2, 130. doi: 10.1186/1752-1947-2-130
Al-Daraji, W. I., Abdellaoui, A., & Salman, W. D. (2005). Osseous metaplasia in a tubular adenoma of the colon. Journal of clinical pathology, 58(2), 220-221.
Bismar, T. A., Maluf, H., & Wang, H. L. (2003). Metastatic foci of signet ring cell carcinoma in a tubular adenoma of the colon. Archives of pathology & laboratory medicine, 127(11), 1509-1512.
White, V., Shaw, A. G., Tierney, G. M., Lund, J. N., & Semeraro, D. (2008). Osseous metaplasia in an ulcerating tubular adenoma of the colon: a case report. Journal of medical case reports, 2(1), 1-3.