Where else can adenomas develop?
Some, not all, people with FAP or attenuated
FAP may develop adenomas in the first part of the small intestine,
Stomach & duodenum
Duodenal adenomas may appear after the colon is removed and
tend to grow much more slowly than colorectal adenomas. Examination
is recommended from the age of 25.
The specially designed fibreoptic tube is called a
endoscope which is passed down the mouth and into the stomach
and duodenum to carefully inspect the lining of the duodenum and
the opening, or ampulla, an area where adenomas may cluster.
The other more commonly used forward-viewing endoscope is unable
to get a clear view of the ampulla which is difficult to see and
is often referred to as a blind spot.
In the stomach, two types
of polyps may be found. The first type is very common and is generally
located in the body, or fundus, of the stomach. When biopsied,
the result is often a diagnosis of benign fundic gland polyps
rather than premalignant polyps. No treatment is necessary and examination
is repeated every 5 years. The second type is an adenoma, generally
isolated and very uncommon in the stomach. Treatment depends on
the degree of change and size of the adenoma.
In the duodenum, most
patients will never develop symptoms from adenomas. Depending on
the biopsy and appearance of the duodenum, side-viewing endoscopy
is repeated at different intervals, ranging from 6 months to 3 years.
Treatment may include laser, surgery, or ongoing observation and
biopsy. Since duodenal adenomas are generally slow-growing and may,
in fact, be rather small in size and number, an operation is generally
not required. New research into medications which can control the
growth of duodenal adenomas is underway. As well, genetic information
may provide a clue to some families where the risk of developing
more extensive duodenal adenomas or duodenal cancer is higher while
others have the same low risk as in the general population.