Familial adenomatous polyposis (FAP) is a rare hereditary syndrome characterized by multiple colorectal polyps and early development of colorectal cancer. Although FAP uniformly involves the large bowel, it may also produce lesions in the stomach and upper intestinal tract. Management of the risk of development of upper gastrointestinal cancer is one of the greatest challenges faced by clinicians involved in the care of polyposis families.
We present the case of a 45-year-old woman with FAP who developed gastric cancer early post proctocolectomy. A gastric adenoma with moderate atypia was detected during the upper gastrointestinal endoscopic screening performed prior to the colorectomy. However, 14 months later, the gastric adenoma had progressed to early gastric cancer. In FAP patients living in East Asia, gastric adenoma is a high risk factor for gastric cancer and shows rapid progression. Therefore, it is important in FAP patients detected to have gastric adenomas, to perform upper gastrointestinal endoscopy in the short term and to resect any gastric adenomas, regardless of their tissue grade.
