Regression of Colorectal Adenomas With Intravenous Cytotoxic Chemotherapy in a Patient With Familial Adenomatous Polyposis

Abstract

1021 Background Familial adenomatous polyposis (FAP) is an autosomally dominant disease. This is a case of a 45 year old woman with FAP and colorectal cancer who showed marked regression of polyps after intravenous chemotherapy. Methods Using PubMed and MEDLINE we searched all citations in English available from 1966 to the present. Search terms included polyps, regression, chemotherapy, colorectal adenomas, and polyposis. Results The patient's colonoscopy in June 2002 revealed hundreds of colorectal adenomas throughout her colon. In June 2002, she had a left hemicolectomy and an liver biopsy. The pathology showed tubular adenomas with metastatic disease in the pericolonic lymph nodes and liver (Stage IV, T3N1M1). Her APC gene test was positive in April 2003. From 9/30/02 to 4/8/03 the patient received 5 cycles of bolus 5-FU, leucovorin, and irinotecan. A colonoscopy on 2/3/03 demonstrated reduced number and size of polyps compared to her prior colonoscopy. Ultrasounds of the liver on 9/25/02 and 11/5/02 ...