{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T10:46:47Z","timestamp":1648982807179},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2021,8,29]],"date-time":"2021-08-29T00:00:00Z","timestamp":1630195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,29]],"date-time":"2021-08-29T00:00:00Z","timestamp":1630195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the Japan Agency for Medical Research and Development","award":["20ck0106556h0001"],"award-info":[{"award-number":["20ck0106556h0001"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin J Gastroenterol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A 28-year-old male visited hospital because his mother had been diagnosed with familial adenomatous polyposis (FAP) with a pathological variant of the <jats:italic>APC<\/jats:italic> gene. Total colonoscopy showed that he has more than 100 polyps distributed throughout the colorectum, and the <jats:italic>APC<\/jats:italic> gene variant was also detected. After he was diagnosed with FAP, he received information that surgery was currently the only way to prevent the development of colorectal cancer. However, he firmly declined to undergo surgical procedures and decided to have strict follow-up with frequent endoscopic polypectomy to prevent the development of colorectal cancer. At the first endoscopy, polypectomy was performed on 52 polyps. Histological analysis of the dissected polyps showed that they were all adenomas, but adenocarcinoma was not detected. The second endoscopic polypectomy was performed after 4\u00a0months later. We found a pale 20\u00a0mm wide flat, elevated type polyp in the ascending colon with an adherent mucus cap that was resistant to washing off. After endoscopic mucosal resection, histological analysis revealed that there were two lesions in the polyps, a sessile serrated lesion (SSL) and SSL with dysplasia. SSL is a high-risk lesion for colorectal cancer, but it was reported to be rare in patients with FAP, and the existence of SSL suggested another carcinogenesis pathway in patients with FAP in addition to the adenoma-carcinoma sequence. Our report may be significant not only in consideration of the pathogenesis of FAP but also useful to raise awareness of SSL for clinicians who perform endoscopic polypectomy to prevent the development of colorectal cancer in patients with FAP.<\/jats:p>","DOI":"10.1007\/s12328-021-01498-0","type":"journal-article","created":{"date-parts":[[2021,8,29]],"date-time":"2021-08-29T06:02:31Z","timestamp":1630216951000},"page":"1667-1670","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Importance of sessile serrated lesions in a patient with familial adenomatous polyposis"],"prefix":"10.1007","volume":"14","author":[{"given":"Motoki","family":"Watanabe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shingo","family":"Ishiguro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michihiro","family":"Mutoh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,29]]},"reference":[{"key":"1498_CR1","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1016\/0092-8674(81)90021-0","volume":"66","author":"J Groden","year":"1991","unstructured":"Groden J, Thliveris A, Samowitz W, et al. Identification and characterization of the familial adenomatous polyposis coli gene. Cell. 1991;66:589\u2013600.","journal-title":"Cell"},{"key":"1498_CR2","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1055\/s-0042-101384","volume":"48","author":"H Ishikawa","year":"2016","unstructured":"Ishikawa H, Mutoh M, Iwama T, et al. Endoscopic management of familial adenomatous polyposis in patients refusing colectomy. Endoscopy. 2016;48:51\u20135.","journal-title":"Endoscopy"},{"key":"1498_CR3","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1136\/gut.50.3.402","volume":"50","author":"T Matsumoto","year":"2002","unstructured":"Matsumoto T, Iida M, Kobori Y, et al. Serrated adenoma in familial adenomatous polyposis: relation to germline APC gene mutation. Gut. 2002;50:402\u20134.","journal-title":"Gut"},{"key":"1498_CR4","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1136\/gut.51.2.200","volume":"51","author":"EJ Sawyer","year":"2002","unstructured":"Sawyer EJ, Cerar A, Hanby AM, et al. Molecular characteristics of serrated adenomas of the colorectum. Gut. 2002;51:200\u20136.","journal-title":"Gut"},{"key":"1498_CR5","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1111\/j.1600-0463.2007.apm_670.x","volume":"115","author":"EJ Lee","year":"2007","unstructured":"Lee EJ, Park CK, Kim JW, et al. Deletion mutation of BRAF in a serrated adenoma from a patient with familial adenomatous polyposis. APMIS. 2007;115:982\u20136.","journal-title":"APMIS"},{"key":"1498_CR6","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.1097\/PAS.0000000000001502","volume":"44","author":"T Okamura","year":"2020","unstructured":"Okamura T, Hashimoto T, Naka T, et al. Clinicopathologic and molecular characteristics of familial adenomatous polyposis-associated traditional serrated adenoma. Am J Surg Pathol. 2020;44:1282\u20139.","journal-title":"Am J Surg Pathol"},{"key":"1498_CR7","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1086\/303058","volume":"67","author":"LK Su","year":"2000","unstructured":"Su LK, Barnes CJ, Yao W, et al. Inactivation of germline mutant APC alleles by attenuated somatic mutations: a molecular genetic mechanism for attenuated familial adenomatous polyposis. Am J Hum Genet. 2000;67:582\u201390.","journal-title":"Am J Hum Genet"},{"key":"1498_CR8","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1007\/BF02281864","volume":"97","author":"W Friedl","year":"1996","unstructured":"Friedl W, Meuschel S, Caspari R, et al. Attenuated familial adenomatous polyposis due to a mutation in the 3\u2019 part of the APC gene. A clue for understanding the function of the APC protein. Hum Genet. 1996;97:579\u201384.","journal-title":"Hum Genet"}],"container-title":["Clinical Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12328-021-01498-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12328-021-01498-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12328-021-01498-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T16:10:11Z","timestamp":1635610211000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12328-021-01498-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,29]]},"references-count":8,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1498"],"URL":"https:\/\/doi.org\/10.1007\/s12328-021-01498-0","relation":{},"ISSN":["1865-7257","1865-7265"],"issn-type":[{"value":"1865-7257","type":"print"},{"value":"1865-7265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,29]]},"assertion":[{"value":"16 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures followed were in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human\/animal rights"}},{"value":"Written informed consent was obtained from the patient in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}