The natural history of gastric adenomas was studied in 26 patients with familial adenomatosis coli (FAC)/Gardner's syndrome. The patients were followed for an average of 6.8 years (1 year, 5 months to 15 years 4 months) and examined repeatedly using gastric radiography, endoscopy, and biopsy. Gastric adenomas were present in 13 (50%). During the follow-up period, there was a new appearance of gastric adenomas in six patients but no distinct change in number, size, and histologic features in the remainiing seven patients. In a 51-year-old man, an antral adenoma that measured 13 mm in diameter and had an irregular central depression did not change in size or morphology during 4 years and 1 month, but malignant change was evident at the time of endoscopic biopsy. The findings indicate that in patients with this disease, gastric adenomas require careful repeated follow-up examinations using endoscopic biopsy and, if feasible, endoscopic removal is recommended.
Camer61:605-611,1988.
HE OCCURRENCE of gastric lesions previously has
T been considered rare in familial adenomatosis coli (FAC) or Gardner's syndrome.'.' Since 1974, however, gastric lesions have been observed in approximately 70% of patients with this disease in Japan.3d More recently, many investigators have observed that the prevalence and histologic appearance of gastric lesions in FAC/ Gardner's syndrome in white persons are similar to those found in the Japanese.'-13 Histologically, such gastric lesions were either adenoma or fundic gland polyposis, or both in most cases, but rarely carcinoma: We reported details of fundic gland polyposis in this disease,I4 but the natural history of those gastric lesions has not been ~larified.'~~'~ This study clarifies the natural course of gastric adenomas in 26 patients with FAC/Gardner's syndrome, who were followed for an average of 6.8 years (1 year, 5 months-15 years, 4 months).
Patients and Methods