Worrisome endoscopic feature in the stomach of patients with familial adenomatous polyposis: the proximal white mucosal patch

Gastric adenocarcinoma (GC) is a recently reported cancer risk in Western patients with familial adenomatous polyposis (FAP).1,2 Most GCs in these FAP patients occur in an area of polyposis in the proximal gastric body or fundus.1 We previously demonstrated that Western FAP patients with GC were more likely than were non-GC FAP control patients to have high-risk endoscopic and histologic features, including a carpeting of proximal gastric polyposis, polypoid mounds of proximal polyps, large solitary polyps, and high-risk histologic features (pyloric gland adenoma, tubular adenoma, and fundic gland polyps with high-grade dysplasia).

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