| Abstract: | A rare case of Familial Adenomatous Polyposis (FAP), associated with colon cancer, ureteral cancer and two early gastric cancers, is reported. A 42-year-old male was admitted to our hospital for evaluation of bloody stools and macrohematuria. There were six FAP patients in his family line, spanning four generations, and five had developed colon cancers. A barium enema revealed diffuse and scattered polyposis throughout the colon and an apple core sign in the descending colon. Abdominal CT disclosed right hydronephrosis with a markedly dilated ureter. Surgery was undertaken and included total colectomy, mucosal proctectomy, ileoanal anastomosis and right nephrectomy with ureteral resection, under a diagnosis of colon cancer and complete right ureteral stenosis. The resected specimens revealed a colon cancer in the descending colon, 50×32×15 mm in size and a ureteral cancer in the lower part of the right ureter, 30×16×16 mm in size. Four years later, he visited our hospital for detailed gastric examination, because gastric abnormalities had been pointed out in a health screening examination. Upper Gl X-ray and endoscopic studies disclosed two cancerous lesions in the gastric antrum, one being a lie lesion in the anterior wall and the other a Ha + lie lesion in the posterior wall. Subtotal gastrectomy was performed and histological study revealed that invasiveness was limited to the submucosa in both lesions. No case of FAP associated with ureteral cancer has previously been reported and only 28 cases with associated gastric cancer have appeared in the Japanese literature. |
