| Abstrakt: |
The authors report five members of a family, having colonic polyposis, whose parents had adenomas that posteriorly degenerated to carcinoma, while sons had juvenile polyposis. Such aspects were considered as familial, evolutive and genetic. In contrast to adenomas, juvenile polyposis or hamartomas were always considered as benign lesions, with no susceptibility to malignancy. Nevertheless, these lesions must be considered as having degenerative potential at least similar to the originating tissue and, perhaps, even higher, once the sick tissue shows abnormal growth rate. These observations raise an important problem, namely, evaluating an eventual existence of malignancy among patients with juvenile polyposis which, if actually confirmed, could result in changes of its concepts and of its therapeutic approaches. The acknowledgement of the association between malignant potenial with genetics, could also result in better prevention for colonic cancer, once known its hereditary predisposition. The expectation of new cases among members of a same family should promote prevention before cancer appears. Thus, with this approach, the transcolonoscopic removal of polyps, mostly among families presenting high cancer potential, should avoid the sequence "adenoma-carcinoma". |
