Clinical Management of Oligopolyposis of Unknown Etiology

AbstractPurpose of reviewCancer risk management for adenomatous oligopolyposis (10 –99 colonic adenomas) depends upon whether the oligopolyposis results from a defined hereditary syndrome. Herein, we summarize genetic testing strategies for evaluation of oligopolyposis and outline colonoscopy and extra-colonic surveillance for individuals without a detectable hereditary syndrome , who have a condition referred to as oligopolyposis of unknown etiology (OPUE).Recent findingsMulti-gene panel genetic testing is appropriate for individuals with 10 or more cumulative colonic adenomas, yet a significant proportion of these individuals lack a molecular diagnosis and are defined clinically as having OPUE. Current consensus guidelines for OPUE surveillance support colonoscopy every 1 –2 years with consideration of surgery if polyp clearance cannot be achieved. Data regarding extra-colonic surveillance is scant; however, screening of the upper gastrointestinal tract, thyroid, and small bowel may be considered on an individualized basis, similar to current clinical practices for familial adenomatous polyposis, despite a lack of strong supporting evidence.SummaryMulti-gene panel genetic testing should be recommended for all individuals with colonic oligopolyposis. Management of OPUE, especially extra-colonic surveillance, remains a challenging area of practice. It is crucial for individuals with OPUE to maintain contact with a specialized gastrointestinal genetics program, as genetic ...
Source: Current Treatment Options in Gastroenterology - Category: Gastroenterology Source Type: research