Original Scientific Articles
Hyperplastic-adenomatous polyposis syndrome

Presented in June 1994 at the Washington State Chapter of the American College of Surgeons, Stevenson, WA.
https://doi.org/10.1016/S1072-7515(99)00019-8Get rights and content

Abstract

Background: Although the syndrome of familial adenomatous polyposis is well known, sporadic patients with multiple polyposis are rare. There are no known syndromes associated with hyperplastic polyposis. In our search of the English surgical literature, we find no reference to a hyperplastic-adenomatous polyposis syndrome.

Study Design: Over a 3-year period, we identified six patients ages 41 to 75 (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 the largest ranged in size from 6 mm to 18 mm. The larger polyps were clinically indistinguishable from adenomas. Three of our six patients had invasive 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 family history of polyposis.

Conclusion: These patients differ from previously described patients with polyposis syndromes; hyperplastic-adenomatous polyposis syndrome (HAPS) occurs in an older population with no family history of polyposis, has fewer polyps, most of which are hyperplastic, and is strongly associated with adenocarcinoma of the colon. In this series, we describe a previously unreported hyperplastic-adenomatous polyposis syndrome.

Section snippets

Methods

Included in this retrospective review were patients that met the following criteria. Patients had to have more than 50 hyperplastic colon polyps and adequate histologic sampling. Full pathologic evaluation was performed after surgical resection. Six cases met these criteria with the vast majority of the polyps being hyperplastic. Table 1 shows clinical features of the patients. All six were men with an age range of 41 to 75 years. The average age was 61 years. The average age of patients with

Results

Table 2, Table 3 demonstrate the pathologic features of the polyps in our six patients. There was no typical presentation. A total count of polyps removed colonoscopically and from surgical specimens revealed more than 50 but less than 100 in every patient. All specimens had multiple hyperplastic as well as adenomatous polyps. Most of the hyperplastic polyps were diminutive; however, 3 were larger than 1.5 cm, with the largest measuring 1.8 cm. All colonic segments were involved with most of

Discussion

A polyp is defined as an identifiable projection above the surrounding surface epithelium. Hyperplastic polyps were first classified by Morson10 in 1962. Grossly, they are pale sessile excrescences commonly seen in the mucosa of the large bowel and are usually smaller than 5 mm.10 Hyperplastic polyps are thought to be from overgrowth and dilation of mature goblet and columnar cells.11 Electron microscopy and in vitro cell kinetic studies have shown that the epithelium of the hyperplastic polyps

References (27)

  • T.S. Whittle et al.

    Giant hyperplastic polyp of the colon simulating adenocarcinoma

    Am J Gastroenterol

    (1978)
  • K.I. Bland et al.

    Colorectal polyps and polyposis syndromes

  • J.W. Fleshman et al.

    Non-neoplastic polyposis syndrome

    Semin Colon Rectal Surg

    (1991)

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