Serrated adenomas of the cardia.

Adenomas of the stomach are histologically classified into tubular and villous adenomas, mixed (tubulovillous) and papillary phenotypes being also recognized. They are localized in the antrum and the body. In a previous work we reported a case of serrated adenoma of the cardia having, at the time of diagnosis, an invasive growth. In this communication we report five newly identified cases of serrated adenomas of the cardia. The five neoplasias were characterized by serrated indentations furnished with dysplastic epithelium. Five out of six serrated adenomas--including the previously reported case--had, in addition, an invasive or a suspected invasive carcinoma. The latter case had at the time of diagnosis lung and liver metastasis. Metastases were also demonstrated in two additional cases. In similarity with other adenoma phenotypes, serrated adenomas of the cardia have a propensity to evolve into invasive carcinoma, a phenomenon that appears to be size-dependent.