PAEA Surgery End Of Rotation (EOR) Practice Exam

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What type of carcinoma is most common after proctocolectomy in patients with familial polyposis?

Colorectal carcinoma
Duodenal carcinoma
Pyloric carcinoma
Gastric carcinoma

The correct answer is: Duodenal carcinoma

In patients with familial polyposis, especially those who have undergone proctocolectomy, the type of carcinoma that is most commonly observed is duodenal carcinoma. This occurs due to the presence of multiple adenomatous polyps in the duodenum, which can lead to the development of cancer over time. Familial adenomatous polyposis (FAP) is characterized by the formation of numerous polyps throughout the gastrointestinal tract, and although colorectal carcinoma is a significant concern, the surgical removal of the colon and rectum (proctocolectomy) leads to the risk of other types of malignancies, particularly in the upper gastrointestinal tract. As a result, surveillance of the duodenum is essential in patients with familial polyposis, even after a proctocolectomy, because the risk for developing duodenal carcinoma increases significantly. Regular endoscopic evaluations are recommended for early detection and management of any neoplastic changes in the duodenum of these patients.