Incidental cancer in colectomy specimens from patients with familial adenomatous polyposis: single centre experience and literature review

Int J Colorectal Dis. 2023 Mar 23;38(1):76. doi: 10.1007/s00384-023-04370-4.

Abstract

Background: Since cancer development is inevitable in patients with familial adenomatous polyposis (FAP), we aimed to determine the incidence of incidental malignancy in prophylactic colectomy specimens.

Methods: The files of patients who underwent prophylactic surgery for FAP between 2010 and 2020 were retrospectively reviewed. The incidence of incidental malignancy in histopathological specimens was examined and a comprehensive literature review was made.

Results: Fifty-five patients were included in the study, of whom 30 patients had a diagnosis of primary malignancy. Prophylactic colectomy was performed on 25 patients. The pathology results indicated that the specimens were benign in 12 patients (48%) and revealed carcinoma in situ in 11 patients (44%). Incidental malignancy was detected in 2 patients (8%). In the literature review, there were 243 patients who underwent prophylactic colectomy and incidental cancer was detected in 25 patients (10.3%) with the stages of 1 (7.4%), 2 (2.1%), and 3 (0.8%), respectively.

Conclusions: Incidental cancer is not rare in patients who have undergone prophylactic colectomy for FAP. Hopefully. they are usually at early stages and unexpected advanced cancers are seen rarely.

Keywords: Adenoma; Cancer; Colectomy; Familial adenomatous polyposis; Rectum.

Publication types

  • Review

MeSH terms

  • Adenomatous Polyposis Coli* / complications
  • Adenomatous Polyposis Coli* / epidemiology
  • Adenomatous Polyposis Coli* / surgery
  • Anastomosis, Surgical
  • Colectomy / adverse effects
  • Humans
  • Incidence
  • Retrospective Studies