Which type of adenoma is linked to the highest risk of cancer?

• A. Villous adenomas
• B. Hyperplastic polyps
• C. Sessile lesions
• D. Uterine fibroids

Answer: (A)

Villous adenomas are considered to have the highest risk of cancer development among the types mentioned. These adenomas are characterized by their extensive, finger-like projections and can be either solitary or multiple. Their histological structure, larger size, and ability to demonstrate dysplastic changes lead to a significant risk of progressing to colorectal cancer. Studies have shown that a higher percentage of villous adenomas harbor carcinoma or exhibit high-grade dysplasia compared to other types of polyps.

In contrast, hyperplastic polyps are generally considered benign and have a lower association with cancer risk. Sessile lesions may present a varying degree of risk depending on their specific characteristics, but they do not intrinsically carry the same cancer risk as villous adenomas. Uterine fibroids, while common in the female population, are benign tumors of the uterus and are not directly linked to an increased risk of cancer.

Thus, the defining features and associated risks of villous adenomas highlight why they are linked to the highest risk of developing cancer compared to the other types listed.