02-25-2008, 06:46 AM
71-year-old Caucasian man comes to see you in the office for a follow-up visit. He recently had his second screening colonoscopy. His first colonoscopy was at age 50. The most recent colonoscopy revealed a 1 cm pedunculated polyp in the sigmoid colon. The polyp and its stalk were completely resected and sent for histopathology, which revealed an adenomatous polyp with an area of well-differentiated adenocarcinoma invading the muscularis mucosa in the head of the polyp. The stalk and the polyp margins were completely free of cancerous tissue. There was no lymphatic or vascular involvement seen in the tissue sample. The patient is otherwise in good health. Which of the following is the most appropriate next step in the management of this patient?
A) Repeat the colonoscopy in one year.
B) Refer the patient for an elective sigmoid resection.
C) Repeat the colonoscopy in three years.
D) Schedule the patient for an elective right hemicolectomy.
E) Refer the patient to a colorectal surgeon for further evaluation.
A) Repeat the colonoscopy in one year.
B) Refer the patient for an elective sigmoid resection.
C) Repeat the colonoscopy in three years.
D) Schedule the patient for an elective right hemicolectomy.
E) Refer the patient to a colorectal surgeon for further evaluation.