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Extracolonic polyps in familial polyposis coli and Gardner's syndrome

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Diseases of the Colon & Rectum

Abstract

Endoscopy and biopsy of the upper gastrointestinal tract and terminal ileum were performed in 24 patients with familial polyposis or Gardner's syndrome in order to further define the incidence of extracolonic adenomatous polyps. Polyps, usually multiple and small in size, were detected in the gastric fundus (12.5 percent), antrum (29.1 percent), duodenum (66.6 percent), and terminal ileum (41.7 percent). Histology showed hyperplasia of the fundic glands and cystic dilatation in the polyps of gastric fundus, and adenomas in several cases of antral (three patients) or duodenal polyps (14 patients). Polyps of the terminal ileum were either adenomas (five patients) or lymphoid aggregates. Patients with stigmata of Gardner's syndrome, desmoids or mesenteric fibromatosis presented a major incidence of adenomas in the duodenum, but not in other parts of the digestive tract investigated. Subsequent checkup after an average of 33 months in ten patients revealed an increase of lesions only in the duodenum in two patients. These findings confirm that adenomatous polyps are not limited to the colon and rectum, as previously believed, but can affect the whole gastrointestinal tract. Periodic surveillance of mucosa seems to be indicated, especially for the duodenum, since degeneration of adenomas into carcinoma is possible

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References

  1. Yao T, Iida M, Ohsato K, Watanabe H, Omae T. Duodenal lesions in familial polyposis of the colon. Gastroenterology 1977;73: 1086–92.

    PubMed  CAS  Google Scholar 

  2. Watanabe H, Enjoji M, Yao T, Ohsato K. Gastric lesions in familial adenomatosis coli: their incidence and histologic analysis. Hum Pathol 1978;9:269–83.

    PubMed  CAS  Google Scholar 

  3. Tonelli F, DeMasi E, Astarita C, Nardi F. Gastric and duodenal polyps associated with familial polyposis coli: personal experience and review of the literature. Ital J Gastroenterol 1981;13 32–9

    Google Scholar 

  4. Capps WF, Lewis MI, Gazzaniga DA. Carcinoma of the colon, ampulla of Vater and urinary bladder associated with familial multiple polyposis: a case report. Dis Colon Rectum 1968:11: 298–305.

    PubMed  Google Scholar 

  5. Hamilton SR, Bussey HJ, Mendelshon G, et al. Ileal adenomas after colectomy in nine patients with adenomatous polyposis coli/Gardner's syndrome. Gastroenterology 1979;77:1252–7.

    PubMed  CAS  Google Scholar 

  6. Grosberg SJ. Gardner's syndrome and villous adenoma of jejunum. Am Surg 1975;41:177–8.

    PubMed  CAS  Google Scholar 

  7. Ohsato K, Yao T, Watanabe H, Iida M, Itoh H Small-intestinal involvement in familial polyposis diagnosed by operative intestinal fiberscopy: report of four cases. Dis Colon Rectum 1977;20:414–20.

    PubMed  CAS  Google Scholar 

  8. Ranzi T, Castagnone D, Velio P, Bianchi P, Bolli EE. Gastric and duodenal polyps in familial polyposis coli. Gut 1981;22:363–7.

    PubMed  CAS  Google Scholar 

  9. Järvinen H, Nyberg M, Peltokallio P. Upper gastrointestinal tract polyps in familial adenomatosis coli. Gut 1983;24:333–9.

    PubMed  Google Scholar 

  10. Burt RW, Berenson MM, Lee RG, Tolman KG, Freston JW, Gardner EJ. Upper gastrointestinal polyps in Gardner's syndrome. Gastroenterology 1984;86:295–301.

    PubMed  CAS  Google Scholar 

  11. Iida M, Yao T, Ohsato K, Itoh H, Watanabe H Diagnostic value of intraoperative fiberscopy for small-intestine polyps in familial adenomatosis coli. Endoscopy 1980;12:161–5.

    Article  PubMed  CAS  Google Scholar 

  12. Smith WG, Kern BB. The nature of the mutation in familial multiple polyposis: papillary carcinoma of the thyroid, brain tumors, and familial multiple polyposis. Dis Colon Rectum 1973;16:264–71.

    PubMed  CAS  Google Scholar 

  13. Thompford NR, Greenberger NJ. Lymphoid polyps of the ileum associated with Gardner's syndrome. Arch Surg 1968;96:289–91.

    Google Scholar 

  14. Dorazio RA, Whelan TJ Jr. Lymphoid hyperplasia of the terminal ileum associated with familial polyposis coli. Ann Surg 1971; 171:300–2.

    Article  Google Scholar 

  15. Shull LN Jr, Fitts CT. Lymphoid polyposis associated with familial polyposis and Gardner's syndrome. Ann Surg 1974;180: 319–22.

    Article  PubMed  Google Scholar 

  16. Dirschmid K, Schobel B. Ileal adenomas in adenomatosis of the large intestine. Endoscopy 1983;15:275–6.

    PubMed  CAS  Google Scholar 

  17. Jones TR, Nance FC. Peryampullary malignance in Gardner's syndrome. Ann Surg 1977;185:565–73.

    Article  PubMed  CAS  Google Scholar 

  18. Bussey HJ. Familial polyposis coli, Baltimore: Johns Hopkins University Press, 1975.

    Google Scholar 

  19. Halsted JA, Harris EJ, Bartlett MK. Involvement of the stomach in familial polyposis of the gastro-intestinal tract. Gastroenterology 1950;15:763–70.

    PubMed  CAS  Google Scholar 

  20. Ross JE, Mara JE. Small bowel polyps and carcinoma in multiple intestinal polyposis. Arch Surg 1974;108:736–8.

    PubMed  CAS  Google Scholar 

  21. Heffernon EW, Metcalfe O, Schwarz HJ Jr. Polyposis of the small and large bowel with carcinoma in a villous polyp of the jejunum: report of a case. Gastroenterology 1962;42:60–2.

    PubMed  CAS  Google Scholar 

  22. Case records of the Massachusetts General Hospital. Case 47-1978. N Engl J Med. 1978;299:1237–45.

    Google Scholar 

  23. Phillips LG. Polyposis and carcinoma of the small bowel and familial colonic polyposis. Dis Colon Rectum 1981;24:478–81.

    PubMed  Google Scholar 

  24. Roth JA, Logio T Carcinoma arising in an ileostomy stoma: an unusual complication of adenomatous polyposis coli. 1982;49: 2180–4.

    CAS  Google Scholar 

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Tonelli, F., Nardi, F., Bechi, P. et al. Extracolonic polyps in familial polyposis coli and Gardner's syndrome. Dis Colon Rectum 28, 664–668 (1985). https://doi.org/10.1007/BF02553447

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  • DOI: https://doi.org/10.1007/BF02553447

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