Ampullary, periampullary, and duodenal adenomas commonly occur in familial adenomatous polyposis (FAP). Their detection and management are fraught with challenges related to balancing the risk of progression to carcinoma and risks of endoscopic management. In this study, the authors sought to characterize the natural history of FAP-related ampullary adenomas (AA) among patients with at least two surveillance endoscopies recorded in a hereditary cancer registry. Clinical and pathologic parameters were compared between those with versus those without clinically significant progression (SP), as reflected by the development of advanced histology or progression to size >10 mm. <\/p>\n\n\n\n
Among 143 patients followed for a median of 7.8 years, SP occurred in 28.6%, including growth in size to \u226510 mm in 15.6%, development of advanced histology in 8.5%, and changes in both histology and size in 4.9%. Ampullary cancer developed in 2 of 143 patients (1.4%). Features associated with SP included prior extracolonic malignancy, prior cholecystectomy, male gender, and abnormal papillary findings at the time of initial AA detection. Adenomatous Polyposis Coli<\/em> gene variants and Spigelman stage did not correlate with progression. During 8.2 years of surveillance, 24% of patients with AA underwent either duodenectomy (n=3) or endoscopic papillectomy (n=23) for their lesions. Most patients did not require excision or ablation of ampullary adenomas, and progression to cancer was rare.<\/p>\n","protected":false},"excerpt":{"rendered":" Ampullary, periampullary, and duodenal adenomas commonly occur in familial adenomatous polyposis (FAP). Their detection and management are fraught with challenges related to balancing the risk of progression to carcinoma and risks of endoscopic management. In this study, the authors sought to characterize the natural history of FAP-related ampullary adenomas (AA) among patients with at least … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,67],"tags":[3034,2172,2067,2128,3035,3036],"class_list":["post-11196","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-bauchspeicheldruese-pankreas","tag-ampullary-and-duodenal-cancers","tag-familial-adenomatous-polyposis","tag-fap","tag-pancreatobiliary","tag-significant-progression","tag-sp"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/11196","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=11196"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=11196"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=11196"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}