Document Detail

Synchronous primary carcinomas of the ampulla of Vater and ascending colon in a patient with multiple flat adenomas.
MedLine Citation:
PMID:  14716059     Owner:  NLM     Status:  MEDLINE    
Multiple primary cancers occurring in the same patients have been reported to represent 1.8-3.9% of all cancers. The majority of all patients reported to have had a combination of simultaneous neoplastic changes in the ampulla of Vater and the colon showed familial adenomatous polyposis (FAP) syndrome. Variants of familial adenomatous polyposis coli are: attenuated adenomatous polyposis coli (AAPC, previously also known as flat adenoma syndrome) and multiple adenoma coli. AAPC is characterized clinically by many, but usually fewer than 100, colonic lesions that are characteristically slightly elevated and plaque-like, with a reddish surface and sometimes central depression. Genetically it represents an extremely rare variant of FAP. Another group of individuals, so-called multiple adenoma patients, have a phenotype similar to AAPC, but most have no demonstrable germ-line adenomatous polyposis coli mutation, as do patients with FAP or AAPC. However, there have been only a few reports that discussed concurrent neoplastic changes in the ampulla of Vater and colon in patients with multiple colonic flat adenomas, but without the florid phenotype of classical FAP. We present rare clinical course of a patient with multiple (more than 60) flat adenomas in the proximal colon and two primary cancers: of the ampulla of Vater and of the ascending colon. This patient and his family history did not show polyposis compatible with FAP or hereditary nonpolyposis colorectal cancer (HNPCC) syndrome.
Marko Doko; Mario Zovak; Elizabet Glavan; Mario Kopljar; Davor Tomas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of gastrointestinal cancer     Volume:  33     ISSN:  1537-3649     ISO Abbreviation:  Int J Gastrointest Cancer     Publication Date:  2003  
Date Detail:
Created Date:  2004-01-12     Completed Date:  2004-03-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  101135379     Medline TA:  Int J Gastrointest Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  117-21     Citation Subset:  IM    
Department of Surgery, University Hospital Sestre Milosrdnice, Vinogradska 29, 10 000 Zagreb, Croatia.
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MeSH Terms
Adenomatous Polyposis Coli / pathology*
Ampulla of Vater / pathology*
Carcinoma / genetics,  pathology*
Colonic Neoplasms / genetics,  pathology*
Common Bile Duct Neoplasms / genetics,  pathology*
Middle Aged
Neoplasms, Multiple Primary / pathology*

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