From the Guidelines
Adenomatosis, also known as adenomatous polyposis syndrome, is a condition characterized by the presence of multiple adenomas, which are benign tumors that develop from glandular epithelial tissue, and is often associated with an increased risk of colorectal cancer and other complications. This condition can affect various organs in the body, most commonly the colon, liver, and endocrine glands. The management of adenomatosis depends on the specific type, location, and symptoms, and may involve regular screenings, removal of polyps, and prophylactic surgery to prevent progression to cancer 1.
Types of Adenomatosis
- Colonic adenomatosis: regular colonoscopy screenings are recommended every 1-3 years with removal of polyps as they're detected
- Familial adenomatous polyposis (FAP): a severe form of colonic adenomatosis, often requires prophylactic colectomy to prevent progression to colorectal cancer 1
- Hepatic adenomatosis: management includes lifestyle modifications, such as discontinuing oral contraceptives, weight loss if obese, and monitoring with imaging studies every 6-12 months
- Endocrine adenomatosis: requires targeted treatment based on the affected glands, often involving surgical removal of adenomas and medication to control hormone levels
Genetic Components
Genetic testing is valuable for patients with adenomatosis, as many forms have hereditary components, allowing for family screening and early intervention 1. The underlying mechanism involves dysregulation of cell growth and division in glandular tissues, often due to genetic mutations that disrupt normal cellular control mechanisms.
Recent Guidelines
Recent guidelines for the clinical management of familial adenomatous polyposis (FAP) emphasize the importance of early detection and treatment to prevent progression to colorectal cancer 1. These guidelines recommend regular colonoscopy screenings, removal of polyps, and prophylactic surgery as necessary to manage the condition and reduce the risk of complications.
From the Research
Definition of Adenomatosis
- Adenomatosis, also known as adenomatous polyposis syndrome, refers to a condition characterized by the presence of multiple adenomatous polyps in the gastrointestinal tract 2.
- Adenomatous polyps are benign tumors that have the potential to develop into colorectal cancer over time 3, 4.
Characteristics of Adenomatosis
- The condition is often associated with familial adenomatous polyposis (FAP), a genetic disorder that increases the risk of developing colorectal cancer 2.
- Adenomatosis can also occur in individuals without a family history of the condition, and the risk of developing colorectal cancer is still present 3, 4.
- The presence of multiple adenomas, large adenomas, or adenomas with high-grade dysplasia increases the risk of developing colorectal cancer 3, 4.
Management of Adenomatosis
- Colonoscopy is the procedure of choice for the diagnosis and removal of adenomatous polyps 4.
- Patients with a history of adenomatous polyps should undergo regular surveillance colonoscopies to detect and remove recurrent adenomas 3, 4, 5.
- The frequency of surveillance colonoscopies depends on the individual's risk factors, such as family history, number and size of adenomas, and presence of high-grade dysplasia 3, 4, 5.