[Hereditary mixed polyposis syndrome. First report in Mexico]
José Luis Rocha Ramírez1, Eduardo Villanueva Sáenz, Paulino Martínez Hernández-Magro
1Servicio de Cirugía de Colon y Recto, Hospital de Especialidades Centro Médico Nacional Siglo XXI. Instituto Mexicano del Seguro Social. rochajlrr@aol.com.mx
Objective:
Report for first time in Mexico a case of hereditary mixed polyposis and review the literature.
Background:
The hereditary mixed polyposis syndrome (HMPS) is an uncommon condition, distinguished by presence of a different histological pattern of polyps in digestive tract, clinically manifested by diarrhea, anemia and weight loss.
Case Report:
Male patient, 38 years old, with familiar antecedent (dead sister) with polyps and gastric cancer. With history of a 1 year with bleeding and mucous diarrhea, and weight loss of a 28.6 pounds. Pale at physical examination, without abdominal signs. At blood test with hemoglobin of 9.7 g/dL, and colonoscopy with multiple polyps within colon and rectum, upper endoscopy with a big esophageal polyp and multiple polyps in gastric and duodenal lining smaller than 1 cm. Contrast study of intestine was normal. Histopathologic study of the polyps report mixed pattern of polyps: (hyperplasic-adenomatous, juvenile-adenomatous, adenoma-inflammatory-hyperplasic, hyperplasic-adenomatous with a high degree dysplasia); juvenile in esophagus, and hyperplasic in stomach and duodenum. Patient was undergone to totalproctocolectomy and reconstruction by "J" ileoanal pouch with good outcome, and endoscopic esophageal polypectomy, with actual surveillance.
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