Abstract
A prophylactic gastrectomy is not indicated for patients with familial adenomatous polyposis (FAP) because of the low malignant potential of fundic gland polyposis and gastric adenomas, but it should be kept in mind that the risk of gastric cancer is higher in FAP patients than in the general populations in East Asian countries. Since duodenal carcinoma, including ampullary carcinoma, is a leading cause of death after a prophylactic (procto) colectomy, the management of such premalignant lesions is important. Meticulous endoscopic surveillance or surgical interventions, such as a pancreas-preserving duodenectomy, should be considered in patients with Spigelman stage IV duodenal polyposis, in whom the malignant potential is significantly increased. A transduodenal or endoscopic papillectomy is an alternative approach to adenomas of the duodenal papilla. Desmoid tumors (DTs) frequently occur after a (procto) colectomy. Surgical resection is the preferred approach for intra-abdominal wall DTs. The classification proposed by Church and coworkers is useful for making a decision regarding the management of intraabdominal DTs. Cytotoxic chemotherapy (dacarbazine plus doxorubicin) is a useful regimen for Church stage III/IV disease.
