Gastric serrated adenoma is an apparently rare adenoma phenotype characterized by branched villi exhibiting lateral saw-tooth indentations lined with dysplastic cells. Out of the 21 gastric serrated adenomas now in record, including the case reported here, 76% (n=16) exhibited invasive carcinoma. In contrast, only 15% of the gastric tubular/villous (that is, non-serrated) adenomas reported in the literature revealed invasive growth. Although the cause for the virulent behaviour of gastric serrated adenomas remains elusive, it would appear that not only the degree of severity of the cellular dysplasia but also the serrated ornamental configurations might play a particular role in the unusual virulence of these adenomas.
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