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Metformin combined with endoscopic therapy in patients with familial polyposis associated with carcinoma: A case report

Dong-Jie Sun, Xiao-Jian He, Hai-Tao Li, Bao-Xiang Luo, Lin Zhou, Xiang-Peng Zeng, Da-Zhou Li, Wen Wang

Medicine, 2022

Abstract

Rationale: Familial adenomatous polyposis (FAP) is an autosomal dominant genetic disease, with a very high cancer rate. At present, endoscopic resection of polyps ≥ 1 cm is often chosen for patients with non-cancerous polyps who are unwilling to undergo surgery, and regular review is conducted. Once the polyps are pathologically confirmed to be cancerous, surgical resection of the diseased large intestine is generally recommended, but surgery often leads to a series of complications. So what do you do with cancer patients who don’t want surgery? Patient concerns: A 19-year-old woman presented with intermittent hematochezia with abdominal pain. A colonoscopy revealed hundreds of intestinal polyps. Diagnoses: The patient had a family history of FAP, and there were hundreds of polyps in the intestine. The pathology was adenomatous, and some polyps became cancerous, which met the diagnostic criteria of FAP. Interventions: Endoscopic examination was arranged for the patient, the resection of intestinal polyps ≥ 1 cm was given priority, and other polyps were removed as far as possible. After that, metformin 500 mg orally was given twice a day, and endoscopic follow-up was conducted every 6 months. During each endoscopic follow-up, intestinal polyps ≥ 1 cm were preferred to be removed, and other polyps were removed as far as possible. Outcomes: The patient’s abdominal pain and blood in the stool disappeared after endoscopic treatment. Cancerous polyps were found at the second and…

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