Dysplastic Polyp in a Woman with UC: What Next?

Fouad Moawad, MD

A medication change? Repeat colonoscopy with chromoendoscopy? Colectomy? Other?

A 46-year-old woman with a long standing history of ulcerative colitis undergoes surveillance colonoscopy. She is managed with oral mesalamine. During the procedure, she is noted to have mild pan colitis. One flat 10-mm polyp is seen. Biopsies of this lesion and surrounding tissue demonstrate dysplasia. 

Which of the following would you recommend? Why?

A. Change her medication to an immunomodulator and repeat colonoscopy in 1 year

B. Repeat colonoscopy and perform chromoendoscopy

C. Refer for a colectomy

D. Screen her for primary sclerosing cholangitis

 

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