CASE 1
A 56 year old woman with no previous history of gastrointestinal disease presented with a short history of abdominal pain, altered bowel habit, weight loss, and anaemia. There was no mucus or blood in the stool. Colonoscopy revealed a constricting carcinoma at the hepatic flexure of the transverse colon and numerous sessile and pedunculated polyps both proximal and distal to the tumour. Subtotal colectomy with ileosigmoid anastomosis was performed. The resection specimen showed a Dukes' B adenocarcinoma with vascular invasion and contained 53 polyps, two of which measured 30 mm in diameter and many measured around 15 mm; two further polyps were sampled from the residual colon. Histologically these all proved to be hyperplastic polyps with two polyps showing foci of low grade dysplasia. The patient is still being followed up and 10 further small polyps (largest 8 mm) were found at colonoscopy six months postoperatively. She is a member of a . . . [Full text of this article]