title: Familial adenomatous polyposis in three generations of a single family: a case study.
abstract: BACKGROUND
  Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited syndrome characterized by the development of numerous polyps in the colon and rectum. If left untreated, the affected patients inevitably develop colon cancer by the age of 40 years. A resection of the colon (colectomy) or of the colon and rectum (proctocolectomy) is needed to minimize the risk of cancer.
  
  
  METHODS
  We report a case of FAP through three generations of a single family, in which the grandmother and granddaughter underwent total colectomy with ileoanal anastomosis and did not develop colon cancer, while the son underwent subtotal colectomy with ileorectal anastomosis and developed recurrent rectal cancer. Data regarding timely surgery, surveillance, and chemoprevention are discussed.
  
  
  CONCLUSIONS
  The FAP phenotype determines the type of treatment. In severe polyposis, proctocolectomy with ileoanal anastomosis seems to be the optimal method for minimizing the risk of cancer development. This case report advocates complete rectal removal, especially in cases of poor patient compliance with colonoscopic surveillance.
authors.affiliation: Department of Oncology and Nuclear Medicine, University Hospital for Tumors, Croatia, Poland.
authors.forename: Jure
authors.initials: J
authors.lastname: Murgic
authors.affiliation: Department of Surgical Oncology, University Hospital for Tumors, Croatia, Poland.
authors.forename: Iva
authors.initials: I
authors.lastname: Kirac
authors.affiliation: Department of Oncology and Nuclear Medicine, University Hospital for Tumors, Croatia, Poland.
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Soldic
authors.affiliation: Ljudevit Jurak Department of Pathology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia, Poland.
authors.forename: Davor
authors.initials: D
authors.lastname: Tomas
authors.affiliation: Department of Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia, Poland.
authors.forename: Mario
authors.initials: M
authors.lastname: Zovak
authors.affiliation: Department of Oncology and Nuclear Medicine, University Hospital for Tumors, Croatia, Poland.
authors.forename: Ante
authors.initials: A
authors.lastname: Bolanca
authors.affiliation: Institute of Human Genetics, Polish Academy of Sciences, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Plawski
authors.affiliation: Department of General Surgery, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Y
authors.initials: Y
authors.lastname: Banasiewicz
authors.affiliation: Department of Oncology and Nuclear Medicine, University Hospital for Tumors, Croatia, Poland.
authors.forename: Zvonko
authors.initials: Z
authors.lastname: Kusic
keywords: 2805C>G substitution; Colectomy; Familial adenomatous polyposis; Rectal cancer