Question

All of the following statements regarding malignant potential of colorectal polyps are true EXCEPT

• A. Polyps of familial polyposis coli could undergo malignant change
• B. Pseudopolyps of ulcerative colitis have a high risk of malignancy
• C. Villous adenoma is associated with high risk of malignancy
• D. Juvenile polyps have little or no risk

Hint:

Pseudopolyps in ulcerative colitis are inflammatory, not neoplastic; the cancer risk in UC comes from the surrounding flat mucosa, not the pseudopolyps.

Answer 1

The Correct Option is B

Step 1: Understanding the Question.
We need to find the one FALSE statement among four claims about the cancer risk of different types of colorectal polyps.

Step 2: Key Concept.
Colorectal polyps are grouped mainly as neoplastic (adenomatous) polyps, which carry real malignant potential, and non-neoplastic polyps, such as hyperplastic, hamartomatous, or inflammatory (pseudo) polyps, which are largely benign growths without their own cancer risk, unless a genetic syndrome is present.

Step 3: Detailed Explanation.
Option (1), familial adenomatous polyposis: patients carry hundreds to thousands of adenomatous polyps, and without treatment nearly all of them progress to colorectal cancer by middle age. So this statement is true.
Option (2), pseudopolyps of ulcerative colitis: these are inflammatory, regenerative islands of mucosa left behind after repeated ulceration and healing in chronic colitis. They are not neoplastic tissue and do not themselves turn malignant. The raised cancer risk in long standing ulcerative colitis comes from dysplasia developing in the flat surrounding mucosa, not from the pseudopolyps. So calling pseudopolyps high risk for malignancy is false, this is the exception we are looking for.
Option (3), villous adenoma: among adenomatous polyps, villous architecture carries the highest risk of harboring cancer compared with tubular or tubulovillous types, especially in larger polyps. So this statement is true.
Option (4), juvenile polyps: these are hamartomatous polyps typically seen in children, and isolated sporadic juvenile polyps carry little or no malignant potential (the risk rises only in juvenile polyposis syndrome with multiple polyps). So this statement is true.

Step 4: Final Answer.
The false statement is that pseudopolyps of ulcerative colitis carry a high risk of malignancy, option (2).