| [ Summary ] |
A 22-year-old man was admitted to the hospital with melena and severe anemia. Using endoscopic examination and barium enema, the condition was diagnosed as familial adenomatous polyposis (FAP) because of the observation of a great number of polyps in the colon and rectum. Total colectomy, mucosal proctectomy and ileoanal anastomosis, along with a J -pouch were performed. The resected specimen revealed the following types of lesions ; early carcinoma type IIc+IIa (5x2.5mm, sm, sigmoid colon), advanced carcinoma type 2 (8x8mm, mp, rectum) along with lymph node metastasis, a laterally spreading tumor of a granular type (4.5x3.8cm, tubular adenoma with severe atypia, descending colon), two lesions of early carcinoma with polypoid type and many polyps (2,171 lesions). In two depressed type carcinomas, no adenomaial components were detected microscopically. It is, therefore, suggested that in this case the depressed lesions might be de novo carcinomas in FAP. |