Benign and Malignant Tumors of the Colon

Haggitt classification describes the structure of an adenomatous polyp that has undergone neoplastic changes: up to level 2 infiltration, polyps can be treated by local excision (endoscopic polypectomy), whereas level 3 and 4 require formal surgical removal in the form of segmental colectomy. Infiltration in sessile polyps more often reaches level 4. Proctocolectomy is recommended for all individuals with FAP because of its universal malignant potential. Colorectal cancer (CRC) is the most common GI malignancy that occurs as a result of a disturbed balance between oncogene and tumor suppressor gene. Astler-Coller modifications of Dukes staging and TNM staging are commonly used for colon cancer. Colonoscopy and CECT are standard investigations required for preoperative diagnosis as well as staging of the disease. Segmental excision of the colon for cancer is based on the lymphovascular pedicle. Indications for chemotherapy in colorectal cancer include all patients with T3 lesions, positive lymph nodes, major vein involvement, signet cell carcinoma, or elevated preoperative CEA levels. Patients with isolated liver or lung metastases can undergo surgery for both the primary and metastatic lesions, as resection often achieves reasonable disease control.