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. 2023 May 23;58(8):705–717. doi: 10.1007/s00535-023-02003-9

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Case of suspected rapid progression from a sessile serrated lesion with dysplasia (SSLD) to advanced cancer. a A 5 mm sized sessile-type lesion with stool and mucus adhesion, located in the transverse colon. A 3 mm sized area of no vessel visibility (white arrow) accompanying the lesion suggests the presence of a flat serrated lesion. The lesion was retrospectively diagnosed as an SSLD of 8 mm in diameter. b The patient had anticoagulant therapy and did not give consent for immediate endoscopic treatment. After 8 months, follow-up endoscopy showed 20 mm sized Type 1 (polypoid type) advanced colon cancer with a loss of surface glandular structure. Postoperative diagnosis was advanced colon cancer (pT2N1M0 and pStage IIIA, UICC)