Pancreaticobiliary involvement in familial polyposis coli/Gardner's syndrome

Adenomatous lesions and carcinoma of the upper gastrointestinal tract, biliary tree, and gallbladder are being reported with increasing frequency in patients with familial polyposis coli or Gardner's syndrome (FPC/GS). A patient with FPC/GS who developed polyps with carcinoma in situ of the common bile duct and ampulla of Vater, along with extensive adenomatous changes in the duodenum, gallbladder, extrahepatic bile ducts, and main pancreatic duct is presented. Proliferative lesions, adenomas, and carcinomas should always be considered in the differential in patients with FPC/GS who have symptoms of upper gastrointestinal, biliary or pancreatic disease.