Carcinomatous Mucosal Excrescence of the Rectum

There has been much discussion as to the pathogenesis of intestinal polyps and the possible evolution of benign adenomas into invasive carcinomas. No direct valid evidence of such a transformation has been offered, because of the necessity for complete removal of a lesion for microscopic examination to permit determination of its true histopathological character, thus rendering further study in situ impossible. However, considerable collateral evidence for malignant transformation is presented both on histological grounds, by Atwater and Bargen,¹and on a clinical basis, by Helwig.²It is generally agreed that colonic polyps, if not already malignant, are potentially malignant and that, whenever observed, they should be extirpated, whether or not they are at the time producing symptoms. With regard to the smaller polyps, sometimes referred to as mucosal excrescences, there are, however, statements in the literature that tend to create a more complacent attitude. In many instances, these