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malignant pedunculated polyp
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malignant pedunculated polyp

I had a colonoscopy, The procedure revealed a malignant pedunculated polyp (1.4-1.8c, diameter), 40 cm high in the Sigmoid colon (the polyp  was removed during the colonoscopy).
The pathological results of the biopsy were: Malignant Pedunculated polyp in the sigmoid colon,  well differentiated with high grade dysplasia and focus of invasive adenocarcinoma arising in villous adenoma . No vascular lymphatic  invasion seen.
The polyprectomy margins were checked  and the result was that the tumor is present 1.5mm from the polyprectomy margin
Lynch syndrome was ruled out in an immunohystochemestry coloration and MSI. The results:  MLH1, PMS2, MSH2, MSH6, were all positive.
Abdomen and hip CT, upper abdomen and little hip ultrasounds and chest x-rays were all normal.
Cancer markers were:
• ca-125 = 6.1 u/ml ;
• Ca-19.9=3.9 u/ml ;
• Cea   less  then  1.3 mg/ml ;
After 3 month, I had a second  advanced HD endoscopy performed. A sessile(ls) polyp was found and removed. It was ascending, 0.4 mm, adenomatous – advanced 211.3 . In addition, during this second endoscopy, an additional biopsy was taken from the previous polyprectomy area. All results were benign.
My family history:
• My father passed away at the age of 66 from cancer. Origin of cancer was unknown, but adenocarcinoma tissue was found in biopsy.
• My mother’s brother survived colon cancer after undergoing surgery.
Doctors here are divided in their opinions regarding going through surgery. I understand my case is probably border line, so considering your vast experience, I would greatly appreciate your opinion and recommendation as to how to proceed.
1)Do you recommend undergoing surgery to remove part of the colon and biopsy the glands?
2) Which follow up tests and frequency do you recommend in the future?
3)Should I check other genetic diseases?
4) Do you have any recommendations for my sons and sister?
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