Successful resection of ampullary carcinoma in a father and adenoma in a daughter with familial adenomatous polyposis following detection by surveillance: report of two cases.
This report describes the successful resection of ampullary carcinoma in a 58-year-old man and an adenoma in his 28-year-old daughter after they had undergone proctocolectomy for familial adenomatous polyposis (FAP). Both patients had been monitored by surveillance endoscopy once a year since their proctocolectomy. The father was found to have an ampullary adenoma 26 years after proctocolectomy, and ampullary carcinoma was detected 2 years later, for which pancreatoduodenectomy was performed. Histological examination of the specimen revealed an ampullary carcinoma, 2.5 x 1.7 cm, that had invaded the submucosal layer, but no lymph node metastasis was found. The patient's daughter underwent endoscopy, which showed an ampullary polyp 6 years after total colectomy. Endoscopic mucosal resection of the periampullary lesion was performed, and histological examination revealed a dysplastic tubular adenoma 0.6 x 0.4 cm in diameter. This report reinforces the importance of long-term periodic surveillance of patients with FAP by gastroduodenal endoscopy.
Takahashi
M
M
Division of Surgery, Yokohama Municipal Citizen's Hospital, Japan.
Minabe
D
D
Kotani
A
A
Kito
F
F
Koganei
K
K
Fukushima
T
T
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D000236:Adenoma / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D011125:Adenomatous Polyposis Coli / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D014670:Ampulla of Vater; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003082:Colectomy; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D004384:Duodenoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D016896:Treatment Outcome