NONPOLYPOID ADENOMAS OF THE DUODENUM IN PATIENTS WITH FAMILIAL ADENOMATOUS POLYPOSIS (GARDNERS-SYNDROME)

Background: Although duodenal adenomas are very common in familial ade nomatous polyposis, we wished to emphasize our experience with finding nonpolypoid adenomas in the duodenum of patients with this disease. M ethods: Duodenoscopy was performed in 23 patients with an established diagnosis of familial adenomatous polyposis or Gardner's syndrome. Res ults: Endoscopy revealed single or multiple nonpolypoid adenomas of th e duodenum in 7 patients (30%). The lesions were smaller than 5 mm and were endoscopically recognized as flat or depressed reddish lesions; one lesion was completely flat and the remaining lesions were flat-top ped elevations with a central depression. All of the lesions were hist ologically diagnosed as tubular adenoma with moderate epithelial atypi a. Conclusion: These findings suggest that duodenal nonpolypoid adenom as are common in familial adenomatous polyposis or Gardner's syndrome and that careful surveillance endoscopy seems necessary in patients wi th this disease.