Familial Adenomatous Polyposis, Gardner's Syndrome and Turcot Syndrome

00:00 HMPCC associated with hereditary nonpolyposis syndrome.

00:06 That is the one which where we talked about when you have right colorectal cancer.

00:10 Meaning of FAP, familial adenomatous polyposis. Autosomal dominant.

00:16 It is a carpet of polyps. This is a young patient and there is going to be 100% chance of going on to colorectal cancer.

00:25 Screening for all members and you do prophylactic colectomy because you know your patient is going on to colorectal cancer. What kind? Left sided. Memorize that, if you haven`t all ready.

00:37 The full molecular talk about a neoplasia.

00:41 Once again, familial adenomatous polyposis.

00:44 You must know about APC, adenomatous polyposis coli, which then controls your beta-catenin. And if your APC has been lost, your beta-catenin is an opposed and brings about excessive transcription.

01:00 With all that transcriptions taking place within your intestinal epithelial cell, you can only imagine that you are going to form carpets of polyps.

01:09 APC, beta-catenin and WMT, all properly regulate your growth and proliferation of your epithelial cell.

01:20 If it is FAP and you have other associations for example, if it is going to be extra intestinal referring to your: S, sebaceous on your skin, O, osteoma a benign bone tumor; D, desmoid and that would be a fibroma and now you called this Gardner´s syndrome.

01:45 Gardner´s syndrome. If you have FAP associated with Turcot, C as in Turcot, you may use this with CCNS, a glioma.

01:58 So you have FAP plus a glioma, you call this Turcot, if you have FAP with your sebaceous osteoma and desmoid, this is then known as your Gardner.

02:10 If you forgotten any component that I have just mention here, for either of the two, please repeat what I just said and make sure that you have firmly implanted those facts into your head.

02:21 So that you know the variants of your familial adenomatous polyposis.

02:24 All of these would be hereditary polyposis syndrome.

02:28 Hereby if you're nonpolyposis also also called Lynch and with HNPCC, this will be on the right side and you have ovarian issues as well.

02:38 Take a look at this. We have a carpet of polyps, either with a colonoscopy, where you find so many polyps and then you open up the colon and when you do so, you find a carpet of polyps on your right.

02:56 Hence, 100% risks of going all to colorectal cancer.

03:01 This has nothing to do, in by that I mean the following.

03:05 You are not going to waste your time trying to figure out what kind of polyp, when he haves so many different polyps, a hundreds and thousands of them.

03:12 You're going on to colorectal cancer. So take it out. Don´t waste time.

03:16 Whereas if you have individual polyps, that's when you start paying attention to, is this villous or tubular.

03:23 Villous or tubular? If it's tubular, it still will be taken out.

03:27 You clip it, but the risk of going on to colorectal cancer technically is decreased.

03:32 Whereas if it's villous, it's the villain, at flat, but it does not being shown here.

03:38 But that has an increase risk of colorectal cancer.