Malignant change in a duodenal adenoma in familial adenomatous polyposis: report of a case.
Patients with FAP (familial adenomatous polyposis) are known to be at high risk for duodenal cancer. Although the adenoma-carcinoma sequence is thought to exist in the duodenum, clinical observation of the development of duodenal adenoma to cancer has rarely been reported. We outline a 44-yr-old postcolectomy man with FAP who underwent regular gastroduodenoscopy annually or biannually and was found to be harboring duodenal ampullary cancer 5 yr after colectomy. Endoscopic and pathological examination of the ampullary lesion during these 5 yr revealed progression of pathology from adenoma to carcinoma. Pathology of the surgical specimen confirmed ampullary cancer. This in vivo demonstration of the adenoma-carcinoma sequence highlights the current limitations of duodenal surveillance in FAP.
Nakatsubo
N
N
Department of Surgery, Hitachi General Hospital, Ibaraki, Japan.
Kashiwagi
H
H
Okumura
M
M
Kamoshida
T
T
Takahashi
A
A
Spigelman
A D
AD
D000236:Adenoma / Q000473:pathology*; D011125:Adenomatous Polyposis Coli / Q000473:pathology*; D000328:Adult; D002277:Carcinoma / Q000473:pathology*; D018450:Disease Progression; D004379:Duodenal Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male