This paper presents a case of familial adenomatous polyposis (FAP) with primary cancers on multiple organs and hepatic metastases.
A 62-year-old woman was admitted to the hospital because of jaundice and epigastralgia. There were previous histories of undergoing a total colectomy for FAP with multiple colonic cancers 4 years before admission, undergoing an endoscopic resection for early gastric cancer 10 months, and having a dilatation of the intrahepatic bile duct 2 years after the colectomy.
A CT scan and a needle biopsy of the liver tumors revealed multiple liver metastases. An endoscopic examination by using a duodenoscope revealed the cancer around the orifice under the swollen papilla.
It was inferred that the papillary cancer may have already occurred 2 years before when the biliary dilatation was found, but was failed to be diagnosed correctly.
Since FAP is a systemic disease, an intensive screening is necessary for other extra-colonic organs.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)