Murakami T, et al. - Researchers conducted this investigation to review clinicopathological characteristics, diagnosis, and treatment of sessile serrated adenoma/polyps (SSA/Ps) with early malignant transformation in the context of previous reports, including the molecular and endoscopic features of those lesions. For this analysis, they studied 462 endoscopically or surgically resected lesions pathologically diagnosed as SSA/P, including 414 without and 41 with cytological dysplasia, and 7 with invasive carcinoma. Clinicopathologically, SSA/Ps with dysplasia or invasive carcinoma were linked to advanced age, female sex, and proximal colon. Endoscopic features, including (semi)pedunculated morphology, double elevation, central depression, and reddishness, can help to diagnose SSA/Ps accurately with advanced histology in an SSA/P series. It was suggested to remove SSA/Ps with dysplasia or invasive carcinoma. Endoscopic treatment like endoscopic mucosal resection or endoscopic submucosal dissection is helpful for those lesions. However, surgical resection with dissection of the lymph node may be indicated when SSA/Ps with invasive carcinoma are endoscopically suspected due to high risk of metastasis of the lymph node.