High prevalence of adenomas and microadenomas of the duodenal papilla and periampullary region in patients with familial adenomatous polyposis

Bertoni, G.; Sassatelli, Romano; Nigrisoli, Evandro; Pennazio, Marco; Tansini, P.; Arrigoni, Arrigo; Leòn, Maurizio Ponz de; Rossini, Francesco Paolo; Bedogni, G.

doi:10.1097/00042737-199612000-00013

Cited by 47 publications

(21 citation statements)

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“…The annual percentage change for cancer of the extrahepatic bile duct is À0.3 which is not statistically significant (P > 0.05) [4]. This sustained increase in cancers of the ampulla is likely related to a continuing increase in the awareness for surveillance, especially for second primary cancers arising in the ampulla after an initial primary colon cancer [12].…”

Section: Discussionmentioning

confidence: 99%

Cancers of the ampulla of vater: Demographics, morphology, and survival based on 5,625 cases from the SEER program

Albores‐Saavedra

Schwartz

Batich

et al. 2009

Journal of Surgical Oncology

259

181

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Section: Discussionmentioning

confidence: 99%

Cancers of the ampulla of vater: Demographics, morphology, and survival based on 5,625 cases from the SEER program

Albores‐Saavedra

Schwartz

Batich

et al. 2009

Journal of Surgical Oncology

259

181

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“…11,12,15,16,[18][19][20][21][22][23][24][25][26][27][28][29] The estimated prevalence of duodenal adenomas depends in part on the methods used for surveillance, including the type of equipment used, whether or not dye spray and magnifying endoscopy is used, and the number of biopsies taken to detect microadenomas. Thus, since duodenal polyps tend to develop around and at the ampulla or more distal part of the duodenum, the use of sideviewing duodenoscopy with multiple biopsies leads to reports at the higher end of the range.…”

Section: Frequency Of Duodenal Cancermentioning

confidence: 99%

Gastroduodenal lesions in familial adenomatous polyposis

Kashiwagi

Spigelman

2000

Surg Today

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Prophylactic colectomy is generally recommended for patients with familial adenomatous polyposis (FAP) who are inevitably affected with large bowel cancer. After prophylactic colectomy has been performed, gastrointestinal malignancy is the leading cause of death. Duodenal adenomas are found in patients with FAP and the adenoma-carcinoma sequence exists in the FAP duodenum, suggesting that treatment of duodenal polyps might be beneficial. Several methods of treatment for duodenal lesions in patients with FAP have been reported, but the current treatment options are not ideal. The nonsteroid anti-inflammatory drugs, sulindac and aspirin, are used for chemoprevention, while recently developed cyclooxygenase-2 inhibitors may be of some use in the future. Endoscopic polypectomy has been attempted for duodenal polyps and open surgical polypectomy has proven to be effective for selected patients. Photodynamic therapy and Argon plasma coagulation may be suitable to treat carpeted polyposis. New methods of duodenal resection, such as pancreas-preserving duodenectomy and pylorus-preserving pancreaticoduodenectomy, might be considered for severe duodenal polyposis; however, because prophylactic duodenal surgery has been considered too aggressive, surveillance duodenoscopy is usually performed to detect duodenal cancer at an early stage.

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“…Because nearly two-thirds of duodenal adenomas occur in the papilla or periampullary region (64) The management of duodenal polyps remains a challenge, with different opportunities for endoscopical, surgical and pharmacological therapy. Prophylactic pancreaticoduodenectomy, either Whipple's operation or pylorus-sparing procedure, is the most hazardous election with procedural mortality rates estimated around 5% (65).…”

Section: Extracolonic Tumor Surveillancementioning

confidence: 99%

Recognition and management of hereditary colorectal cancer syndromes

Herraiz

Muñoz-Navas

2009

Rev. esp. enferm. dig.

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Over 1.900 colorectal tumors will arise in association with a hereditary colorectal cancer syndrome in Spain in 2009.The genetic defects responsible for the most common syndromes have been discovered in recent years.Genetic testing helps diagnose affected individuals and allows identification of individuals at-risk.Colonoscopy and prophylactic colectomy decrease colorectal cancer incidence and overall mortality in patients with hereditary colon cancer.Extracolonic tumors are frequent in these syndromes, so specific surveillance strategies should be offered.Key words: Familial adenomatous polyposis. Lynch syndrome. MYH-associated polyposis. Hereditary colon cancer. INTRODUCTIONIn 2009, it is estimated that around 38,000 people (1) in Spain will be diagnosed with colorectal cancer (CRC). Among these cases, more than 15% will exhibit familial clustering, and over 1,900 tumors (5%) will arise in association with a hereditary colorectal cancer syndrome. The most common hereditary colon cancer syndromes are: Familial Adenomatous Polyposis (FAP), attenuated FAP (AFAP), MYH associated polyposis (MAP), and Lynch syndrome, also known as Hereditary Non-Polyposis Colorectal Cancer syndrome (HNPCC) (2).During the last two decades, the most important advancement has been the identification of the genes that underlie these syndromes. This has permitted more accurate classifications of the various syndromes based upon genetic criteria, and consequently this has resulted in more tailored management strategies based on these criteria (3). The management of individuals with hereditary colon cancer or at-risk for hereditary colon cancer is dramatically different, so recognizing these syndromes is critical. Specifically, surveillance strategies for colon and extra-colonic tumors as well as surgical approaches (4) for the prevention and treatment of cancer reflect the heightened risks.This review is focused on current treatment strategies in hereditary colon cancer. It is important to recognize that "treatment" includes not only management of already diagnosed cancers but also to prevention of cancer in these high-risk populations. We first briefly summarize the major clinical features of each syndrome, including pattern of inheritance and penetrance, age at diagnosis and associated extra-colonic tumors. Familial adenomatous polyposis and attenuated FAPFAP is the most common adenomatous polyposis syndrome. Its prevalence is 1:5.000-10.000, with a uniform worldwide distribution, affecting both genders equally (5). Inherited in an autosomal dominant manner with a virtually penetrance of 100%, it is caused by a germline mutation in the Adenomatous Polyposis Coli (APC) tu- POINT OF VIEWmor suppressor gene on chromosome 5q21 (6). In 15-20%, the cases are "de novo" without clinical or genetic evidence of FAP in the parents (7). Recent studies indicate the presence of mosaicism in approximately 15% of such cases (8,9).Classic FAP is characterized by the development of hundreds to thousands of colorectal adenomas starting during the...

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High prevalence of adenomas and microadenomas of the duodenal papilla and periampullary region in patients with familial adenomatous polyposis

Cited by 47 publications

References 0 publications

Cancers of the ampulla of vater: Demographics, morphology, and survival based on 5,625 cases from the SEER program

Cancers of the ampulla of vater: Demographics, morphology, and survival based on 5,625 cases from the SEER program

Gastroduodenal lesions in familial adenomatous polyposis

Recognition and management of hereditary colorectal cancer syndromes

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