Hyperplastic-adenomatous polyposis syndrome

Background: Although the syndrome of familial adenomatous polyposis is well known, sporadic patients with multiple polyposis are rare. There are no kn own syndromes associated with hyperplastic polyposis. In our search of the English surgical literature, we find no reference to a hyperplastic-adenoma tous polyposis syndrome. Study Design: Over a 3-year period, we identified six patients ages 41 to 7 5 (mean age 61) with 50 to 100 hyperplastic polyps associated with adenomas . Results: Most of the hyperplastic polyps were found in the left colon and t he largest ranged in size from 6 mm to 18 mm. The larger polyps were clinic ally indistinguishable from adenomas. Three of our six patients had invasiv e cancer of the proximal colon. All tumors were confined to the bowel wall. There was a family history of colon cancer in only one patient and no fami ly history of polyposis. Conclusion: These patients differ from previously described patients with p olyposis syndromes; hyperplastic-adenomatous polyposis syndrome (HAPS) occu rs in an older population with no family history of polyposis, has fewer po lyps, most of which are hyperplastic, and is strongly associated with adeno carcinoma of the colon. In this series, we describe a previously unreported hyperplastic-adenomatous polyposis syndrome. (J Am Coll Surg 1999;188:503- 507. (C) 1999 by the American College of Surgeons).