Macroscopic and histologic regression of duodenal polyposis with FOLFOX4 chemotherapy for an ileal pouch adenocarcinoma in a patient with familial adenomatous polyposis

Endoscopy. 2012 Dec;44(12):1165-7. doi: 10.1055/s-0032-1325674. Epub 2012 Nov 27.

Abstract

Severe (stage IV) duodenal polyposis is difficult to manage in patients with familial adenomatous polyposis (FAP), with no effective medical treatment, complex endoscopic treatment modalities, and a high morbidity and mortality from pancreaticoduodenectomy. We present the case of a 44-year-old woman with FAP, stage IV duodenal polyposis, and with an ileal pouch adenocarcinoma that required surgery and adjuvant chemotherapy. Her duodenal polyposis regressed to stage II after four sessions of FOLFOX4 adjuvant chemotherapy, which avoided the need for aggressive endoscopic therapy or pancreatoduodenectomy in this patient.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Adenomatous Polyposis Coli / complications
  • Adenomatous Polyposis Coli / pathology
  • Adenomatous Polyposis Coli / surgery*
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols*
  • Biopsy, Needle
  • Chemotherapy, Adjuvant
  • Colonic Pouches / pathology*
  • Duodenal Neoplasms / complications
  • Duodenal Neoplasms / drug therapy*
  • Duodenal Neoplasms / pathology
  • Duodenal Neoplasms / surgery
  • Duodenoscopy / methods
  • Female
  • Fluorouracil
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Leucovorin
  • Organoplatinum Compounds
  • Proctocolectomy, Restorative / adverse effects
  • Proctocolectomy, Restorative / methods
  • Risk Assessment
  • Treatment Outcome

Substances

  • Organoplatinum Compounds
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol