What Is a Sessile Serrated Adenoma?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 06 November 2018
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A Sessile Serrated Adenoma (SSA) is a neoplasm in the large intestine that can develop into colorectal cancer. It may be identified during routine cancer screening or another procedure on the colon where a doctor spots signs of abnormal cell growth. To determine if a lesion is a sessile serrated adenoma, a pathologist needs to examine a sample of tissue to check for specific characteristics. Pathology reports may take several days or more than a week, depending on the facility and the workload.

This type of growth is also sometimes referred to as a polyp. It is a flat growth rather than a protrusion from the walls of the colon, with abnormal cells that extend into the wall of the intestine. The growth can have a distinctive serrated shape and sometimes appears to mimic normal mucosal folds in the colon until it is examined more closely. Pathologists can stain a sample to highlight cellular structure and review it under a microscope to learn more about it.


The concern with a sessile serrated adenoma is that the growth could become cancerous. Researchers have identified a pathway these growths can use to transition from benign overgrowth to malignancy, and while this doesn’t occur in all cases, having a history of polyps is a cause for concern. In a patient with a family history of colorectal cancer, the growth can be a red flag, while in other patients, it may be a medical indicator that the patient needs closer monitoring. Regular follow-up testing can be used to check for signs of colorectal cancer so it can be identified and treated as early as possible.

Treatment options for a sessile serrated adenoma can depend on the patient’s history and situation. It is possible to remove the growth, or it may be left in place and monitored. Patients can discuss their options both before a biopsy, when a surgeon may have an opportunity to take the whole growth out; and after the procedure, when they are reviewing the biopsy results. Screening recommendations for the future can also be discussed to determine how often the patient needs followups to check for cancer.

In the event a sessile serrated adenoma does develop into colorectal cancer, surgery is usually a first avenue of treatment to remove the tumor and affected section of colon. Neighboring lymph nodes may be removed both to test for metastasis and to ensure that if the cancer did start spreading before it was caught, it won’t be able to keep growing in those nodes. Chemotherapy and radiation can also be considered to kill any remaining cancer cells, control metastasis, and prevent recurrence.


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