Clinical Gastroenterology Vol.29 No.12(6)

Theme Advancement in Diagnosis and Treatment for Duodenal Neoplasms
Title Duodenal Lesions in Familial Adenomatous Polyposis
Publish Date 2014/11
Author Yuji Maehata Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Author Motohiro Esaki Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Author Tomohiko Moriyama Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
Author Shotaro Nakamura Department of R/D for Surgical Support System, Center for Advanced Medical Innovation, Graduate School of Medical Sciences, Kyushu University
Author Takayuki Matsumoto Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University
[ Summary ] Ampullary adenoma and duodenal adenomatosis develop frequently in patients with familial adenomatous polyposis (FAP). The endoscopic appearance of ampullary adenoma is an enlargement with whitish color or a nodular protrusion. Duodenal adenomatosis is endoscopically observed as small protrusions, depressed lesions or nodular aggregating lesions. In the Western and our previous studies, genotypephenotype correlation was observed between APC gene mutation and duodenal adenomatosis. Though patients with FAP are recognized to be at high risk of duodenal and ampullary cancers, most duodenal lesions indicate a static and benign nature. Therefore, aggressive endoscopic or surgical removal seems to be unnecessary and we recommend endoscopic observation for ampullary adenoma and duodenal adenomatosis.
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