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Importance of sessile serrated lesions in a patient with familial adenomatous polyposis
A 28-year-old male visited hospital because his mother had been diagnosed with familial adenomatous polyposis (FAP) with a pathological variant of the APC gene. Total colonoscopy showed that he has more than 100 polyps distributed throughout the colorectum, and the APC gene variant was also detected...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Singapore
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557166/ https://www.ncbi.nlm.nih.gov/pubmed/34455522 http://dx.doi.org/10.1007/s12328-021-01498-0 |
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author | Watanabe, Motoki Ishikawa, Hideki Ishiguro, Shingo Mutoh, Michihiro |
author_facet | Watanabe, Motoki Ishikawa, Hideki Ishiguro, Shingo Mutoh, Michihiro |
author_sort | Watanabe, Motoki |
collection | PubMed |
description | A 28-year-old male visited hospital because his mother had been diagnosed with familial adenomatous polyposis (FAP) with a pathological variant of the APC gene. Total colonoscopy showed that he has more than 100 polyps distributed throughout the colorectum, and the APC gene variant was also detected. After he was diagnosed with FAP, he received information that surgery was currently the only way to prevent the development of colorectal cancer. However, he firmly declined to undergo surgical procedures and decided to have strict follow-up with frequent endoscopic polypectomy to prevent the development of colorectal cancer. At the first endoscopy, polypectomy was performed on 52 polyps. Histological analysis of the dissected polyps showed that they were all adenomas, but adenocarcinoma was not detected. The second endoscopic polypectomy was performed after 4 months later. We found a pale 20 mm wide flat, elevated type polyp in the ascending colon with an adherent mucus cap that was resistant to washing off. After endoscopic mucosal resection, histological analysis revealed that there were two lesions in the polyps, a sessile serrated lesion (SSL) and SSL with dysplasia. SSL is a high-risk lesion for colorectal cancer, but it was reported to be rare in patients with FAP, and the existence of SSL suggested another carcinogenesis pathway in patients with FAP in addition to the adenoma-carcinoma sequence. Our report may be significant not only in consideration of the pathogenesis of FAP but also useful to raise awareness of SSL for clinicians who perform endoscopic polypectomy to prevent the development of colorectal cancer in patients with FAP. |
format | Online Article Text |
id | pubmed-8557166 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Singapore |
record_format | MEDLINE/PubMed |
spelling | pubmed-85571662021-11-15 Importance of sessile serrated lesions in a patient with familial adenomatous polyposis Watanabe, Motoki Ishikawa, Hideki Ishiguro, Shingo Mutoh, Michihiro Clin J Gastroenterol Case Report A 28-year-old male visited hospital because his mother had been diagnosed with familial adenomatous polyposis (FAP) with a pathological variant of the APC gene. Total colonoscopy showed that he has more than 100 polyps distributed throughout the colorectum, and the APC gene variant was also detected. After he was diagnosed with FAP, he received information that surgery was currently the only way to prevent the development of colorectal cancer. However, he firmly declined to undergo surgical procedures and decided to have strict follow-up with frequent endoscopic polypectomy to prevent the development of colorectal cancer. At the first endoscopy, polypectomy was performed on 52 polyps. Histological analysis of the dissected polyps showed that they were all adenomas, but adenocarcinoma was not detected. The second endoscopic polypectomy was performed after 4 months later. We found a pale 20 mm wide flat, elevated type polyp in the ascending colon with an adherent mucus cap that was resistant to washing off. After endoscopic mucosal resection, histological analysis revealed that there were two lesions in the polyps, a sessile serrated lesion (SSL) and SSL with dysplasia. SSL is a high-risk lesion for colorectal cancer, but it was reported to be rare in patients with FAP, and the existence of SSL suggested another carcinogenesis pathway in patients with FAP in addition to the adenoma-carcinoma sequence. Our report may be significant not only in consideration of the pathogenesis of FAP but also useful to raise awareness of SSL for clinicians who perform endoscopic polypectomy to prevent the development of colorectal cancer in patients with FAP. Springer Singapore 2021-08-29 2021 /pmc/articles/PMC8557166/ /pubmed/34455522 http://dx.doi.org/10.1007/s12328-021-01498-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Case Report Watanabe, Motoki Ishikawa, Hideki Ishiguro, Shingo Mutoh, Michihiro Importance of sessile serrated lesions in a patient with familial adenomatous polyposis |
title | Importance of sessile serrated lesions in a patient with familial adenomatous polyposis |
title_full | Importance of sessile serrated lesions in a patient with familial adenomatous polyposis |
title_fullStr | Importance of sessile serrated lesions in a patient with familial adenomatous polyposis |
title_full_unstemmed | Importance of sessile serrated lesions in a patient with familial adenomatous polyposis |
title_short | Importance of sessile serrated lesions in a patient with familial adenomatous polyposis |
title_sort | importance of sessile serrated lesions in a patient with familial adenomatous polyposis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557166/ https://www.ncbi.nlm.nih.gov/pubmed/34455522 http://dx.doi.org/10.1007/s12328-021-01498-0 |
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