J Dig Cancer Res.  2025 Apr;13(1):38-46. 10.52927/jdcr.2025.13.1.38.

Upper Gastrointestinal Neoplasms in Familiar Adenomatous Polyposis

• Noh JH

• KMID: 2567137
• DOI: http://doi.org/10.52927/jdcr.2025.13.1.38

Abstract

Familial adenomatous polyposis (FAP) is an autosomal dominant genetic disorder caused by mutations in the adenomatous polyposis coli gene. FAP is characterized by the development of hundreds to thousands of adenomatous polyps in the colon. While initially the primary concern was colorectal cancer, recent advancements in surveillance and prophylactic colectomy have shifted the focus toward the management of upper gastrointestinal (GI) neoplasms, particularly duodenal and gastric lesions. This review focuses on the epidemiology, clinical features, treatment options, and surveillance strategies for treating upper GI neoplasms in patients suffering from FAP. A review of the risk assessment through the Spigelman classification system and current guidelines for both nonampullary and ampullary lesions was conducted for duodenal neoplasms. Regarding gastric neoplasms, the characteristics and management strategies for fundic gland polyps, gastric adenomas, and cancers were discussed. Overall, early screening and timely removal of suspicious lesions are crucial for the management of upper GI neoplasms in patients with FAP for effective cancer prevention.

Keyword

Duodenal neoplasms; Endoscopy; Familial adenomatous polyposis; Stomach neoplasms