672 Duodenal Adenoma Surveillance for Familial Adenomatous Polyposis Patients Utilizing Endoscopy and Endoscopic Ultrasound: Results of Ten Years of Follow-Up

2014 ◽  
Vol 146 (5) ◽  
pp. S-118
Author(s):  
Nathan Gluck ◽  
Hana Strul ◽  
Guy Rozner ◽  
Moshe Leshno ◽  
Erwin Santo
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Endoscopic Ultrasound ◽  
Adenomatous Polyposis ◽  
Duodenal Adenoma

scholarly journals Endoscopic ultrasound in the assessment of advanced duodenal adenomatosis in familial adenomatous polyposis

2019 ◽  
Vol 6 (1) ◽  
pp. e000336
Author(s):  
Peter L Labib ◽  
George Goodchild ◽  
James P Turbett ◽  
James Skipworth ◽  
Arjun Shankar ◽  
...  
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Cancer Risk ◽  
Endoscopic Ultrasound ◽  
Ampullary Cancer ◽  
Adenomatous Polyposis ◽  
Polyp Size ◽  
Surgical Interventions ◽  
Relative Indication ◽  
Duodenal Adenomatosis

ObjectiveCurrent surveillance strategies for duodenal adenomatosis in familial adenomatous polyposis (FAP) miss malignancies and underestimate cancer risk in ampullary disease. This study aimed to evaluate the utility of endoscopic ultrasound (EUS) in the assessment of FAP patients with duodenal and/or ampullary polyposis referred for surgical intervention.DesignA retrospective analysis of FAP patients undergoing index EUS between December 2006 and May 2015 was performed. Follow-up was completed in January 2018, including review of all EUS procedures and surgical interventions (median follow-up 6 years).ResultsFifty-five patients underwent 188 EUS procedures. Six patients (11%) developed malignancy (three duodenal, three ampullary). Ampullary cancer risk was underestimated by Spigelman stage and overestimated by Kashiwagi classification. Ultrasound findings were poor predictors of malignancy, with common bile duct dilatation being the only finding present in one EUS prior to a diagnosis of ampullary cancer. The best predictors of ampullary malignancy were an ampullary polyp size >3 cm and an increase >1 cm in ampullary polyp size. Ampullary polyp size >3 cm provided the best predictive value, correctly identifying two of the three cases of ampullary cancer and both patients with high-grade dysplasia. EUS biopsy failed to detect malignancy later confirmed by surgical histology in two patients.ConclusionEUS surveillance confers little additional benefit to standard endoscopic surveillance in FAP patients. The best predictor of ampullary malignancy is an ampullary polyp >3 cm; this could be regarded as a relative indication for surgery.

ID: 3524040 THE NATURAL HISTORY OF AMPULLARY ADENOMAS IN FAMILIAL ADENOMATOUS POLYPOSIS SYNDROME: LONG-TERM FOLLOW-UP

2021 ◽  
Vol 93 (6) ◽  
pp. AB350
Author(s):  
Achintya D. Singh ◽  
Amit Bhatt ◽  
Abel Joseph ◽  
Neal Mehta ◽  
Gautam N. Mankaney ◽  
...  
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Natural History ◽  
Adenomatous Polyposis ◽  
Polyposis Syndrome ◽  
Long Term Follow Up ◽  
History Of

scholarly journals Long-term outcomes of metachronous neoplasms in the ileal pouch and rectum after surgical treatment in patients with familial adenomatous polyposis

2019 ◽  
Vol 07 (05) ◽  
pp. E691-E698 ◽  
Author(s):  
Masahiro Tajika ◽  
Tsutomu Tanaka ◽  
Makoto Ishihara ◽  
Yutaka Hirayama ◽  
Sachiyo Oonishi ◽  
...  
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Ileal Pouch ◽  
Maximum Size ◽  
Incidence Rates ◽  
Adenomatous Polyposis ◽  
Significant Incidence ◽  
Long Term Follow Up ◽  
Advanced Adenomas

Abstract Background and study aims Restorative proctocolectomy has become the most common surgical option for patients with familial adenomatous polyposis (FAP). However, adenomas and even carcinomas may develop in the ileal pouch over time. The aim of this study was to evaluate the long-term incidence and nature of ileal pouch or distal ileal adenomas and carcinomas in patients with FAP. Patients and methods This was a retrospective study of 47 FAP patients with Kock’s continent ileostomy (Kock) (n = 8), ileorectal anastomosis (IRA) (n = 13), and ileal pouch-anal anastomosis (IPAA) (n = 26). Patients were followed with a standardized protocol including chromoendoscopy and biopsies of visible polyps in the ileal pouch, distal ileum, and rectum every 6 to 12 months. Results Median follow-up was 21.0 years. Overall risk of adenoma development was significantly higher in IRA patients, with incidence rates of 85 % and 100 % at 5 and 10 years’ follow-up, respectively, compared to pouch patients (Kock + IPAA) (P < 0.001). However, there was also a high frequency of adenomas in the ileal pouch mucosa, with rates of 12 %, 33 %, and 68 %, at 5, 10, and 20 years of follow-up, respectively. Maximum size of ileal pouch adenomas was significantly related to time since surgery (P = 0.0214). Six cases of advanced adenomas including two cases of adenocarcinomas developed in the ileal pouch mucosa. Conclusions There is a significant incidence of adenoma(s) in the ileal pouch of FAP patients on long-term follow-up. Regular endoscopic surveillance is recommended, not only in IRA patients, but also in pouch patients after proctocolectomy.

scholarly journals Gene Expression Changes Accompanying the Duodenal Adenoma-Carcinoma Sequence in Familial Adenomatous Polyposis

2019 ◽  
Vol 10 (6) ◽  
pp. e00053 ◽  
Author(s):  
Sushrut S. Thiruvengadam ◽  
Margaret OʼMalley ◽  
Lisa LaGuardia ◽  
Rocio Lopez ◽  
Zhen Wang ◽  
...  
Keyword(s):  
Gene Expression ◽  
Familial Adenomatous Polyposis ◽  
Adenomatous Polyposis ◽  
Duodenal Adenoma

scholarly journals Gastric adenomas and their management in familial adenomatous polyposis

Endoscopy ◽  
2020 ◽  
Author(s):  
Isabel Martin ◽  
Victorine H. Roos ◽  
Chukwuemeka Anele ◽  
Sarah-Jane Walton ◽  
Victoria Cuthill ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Familial Adenomatous Polyposis ◽  
Initial Diagnosis ◽  
Gastric Adenoma ◽  
Adenomatous Polyposis ◽  
Recurrence Rates ◽  
Patient Demographics ◽  
Increased Risk ◽  
Piecemeal Resection

Abstract Background Patients with familial adenomatous polyposis (FAP) are at increased risk of developing gastric adenomas. There is limited understanding of their clinical course and no consensus on management. We reviewed the management of gastric adenomas in patients with FAP from two centers. Methods Patients with FAP and histologically confirmed gastric adenomas were identified between 1997 and 2018. Patient demographics, adenoma characteristics, and management/surveillance outcomes were collected. Results Of 726 patients with FAP, 104 (14 %; 49 female) were diagnosed with gastric adenomas at a median age of 47 years (range 19 – 80). The median size of gastric adenomas was 6 mm (range 1.5 – 50); 64 (62 %) patients had adenomas located distally to the incisura. Five patients (5 %) had gastric adenomas demonstrating high-grade dysplasia (HGD) on initial diagnosis, distributed equally within the stomach. The risk of HGD was associated with adenoma size (P = 0.04). Of adenomas > 20 mm, 33 % contained HGD. Two patients had gastric cancer at initial gastric adenoma diagnosis. A total of 63 patients (61 %) underwent endoscopic therapy for gastric adenomas. Complications occurred in three patients (5 %) and two (3 %) had recurrence, all following piecemeal resection of large (30 – 50 mm) lesions. Three patients were diagnosed with gastric cancer at median follow-up of 66 months (range 66 – 115) after initial diagnosis. Conclusions We observed gastric adenomas in 14 % of patients with FAP. Of these, 5 % contained HGD; risk of HGD correlated with adenoma size. Endoscopic resection was feasible, with few complications and low recurrence rates, but did not completely eliminate the cancer risk.

Pancreaticoduodenectomy for Dysplastic Duodenal Adenoma in a Patient with Familial Adenomatous Polyposis

2008 ◽  
Vol 94 (6) ◽  
pp. 882-884
Author(s):  
Roberto Merenda ◽  
Giuseppe Portale ◽  
Francesca Galeazzi ◽  
Chiara Tosolini ◽  
Giacomo Carlo Sturniolo ◽  
...  
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Colonic Polyps ◽  
Clinical History ◽  
Adenomatous Polyposis ◽  
Duodenal Adenoma ◽  
Colorectal Polyposis ◽  
Duodenal Polyps ◽  
Younger Age ◽  
History Of ◽  
Malignant Lesions

Colorectal polyposis is the main feature of familial adenomatous polyposis (FAP), but benign and malignant lesions have also been described in the stomach, duodenum, small bowel, biliary tract and pancreas. There are few reports on FAP patients with duodenal polyps that developed at a younger age and even fewer on cases with dysplastic degeneration. The progression to carcinoma usually presents quite late in the clinical history of FAP patients, typically at least 20 to 25 years after proctocolectomy. This report described the rare case of a patient presenting with duodenal adenomas with dysplastic changes and tumor infiltration as the first sign of FAP, who was treated by pancreaticoduodenectomy followed by proctocolectomy for subsequent dysplastic changes in colonic polyps.

Dento-osseous anomalies in patients with familial adenomatous polyposis: A follow-up study

2020 ◽  
Vol 24 (10) ◽  
pp. 3501-3511
Author(s):  
Fabiana Tolentino Almeida ◽  
André Ferreira Leite ◽  
Paulo Tadeu de Souza Figueiredo ◽  
Pollyanna Almeida Costa dos Santos ◽  
Erica Carine Campos Caldas Rosa ◽  
...  
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Adenomatous Polyposis ◽  
Follow Up Study
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