[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-460853-105":59,"doc-detail-460853-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","challenging-aspects-of-familial-adenomatous-polyposis-with-malignant-transformation-a-report-of-two-cases","Challenging Aspects of Familial Adenomatous Polyposis With Malignant Transformation - A Report of Two Cases","","Familial adenomatous polyposis (FAP) is a genetic disorder marked by early-onset hundreds of gastrointestinal polyps, mainly in the colon and rectum. Although uncommon, Moroccan data are limited because there is no national registry and few comparative series. Two Moroccan cases are presented: initial colonoscopy found over 100 polyps with adenomatous features and varied pathology, including low-grade adenomas and colorectal cancers. Management included surgery and recommended duodenal surveillance.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/challenging-aspects-of-familial-adenomatous-polyposis-with-malignant-transformation-a-report-of-two-cases/460853/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/challenging-aspects-of-familial-adenomatous-polyposis-with-malignant-transformation-a-report-of-two-cases/460853.png","ImageObject",300,407,{"name":92,"@type":93},"WPS_1786070896","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",15,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is familial adenomatous polyposis and why is it clinically important?","Question",{"text":113,"@type":114},"FAP is a rare autosomal dominant genetic disorder causing early hundreds of polyps in the gastrointestinal tract, mainly the colon and rectum. It carries a high risk of early-onset malignancy without proper management.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What did colonoscopy and chromoendoscopy show in the two reported cases?",{"text":118,"@type":114},"Initial colonoscopy showed more than 100 polyps in both patients. The polyps varied in size and morphology across the colon and rectum and showed adenomatous features on virtual chromoendoscopy.",{"name":120,"@type":111,"acceptedAnswer":121},"How were the patients managed and what surveillance was recommended?",{"text":122,"@type":114},"Both patients underwent surgery: one with subtotal colectomy and ileorectal anastomosis, the other with total proctocolectomy and ileoanal anastomosis. Regular surveillance of duodenal polyps was recommended every 1–2 years.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},460853,1790909149,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},549768072016,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Review began 11/14/2025  \nReview ended 12/07/2025  \nPublished 12/09/2025  \n© Copyright 2025  \nBelabbes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98789  \nOpen Access Case Report  \nChallenging Aspects of Familial Adenomatous Polyposis With Malignant Transformation: AReport of Two Cases  \nFatima Zahra Belabbes 1, 2, Sara Mounsif 1, 2, Rania Arja 1, 2, Basma Elkhannoussi 3, 2 , Imane Ben Elbarhdadi 1, 2  \n1. Department of Gastroenterology and Hepatology, Mohammed VI University of Health Sciences, Cheikh Khalifa International University Hospital, Casablanca, MAR 2. Research Unit, Mohammed VI Center for Research and Innovation, Rabat, MAR 3. Department of Pathology, Mohammed VI University of Health Sciences, Cheikh Khalifa International University Hospital, Casablanca, MAR  \nCorresponding author: Sara Mounsif, [sara.mounsif@gmail.com](sara.mounsif@gmail.com)  \nAbstract  \nFamilial adenomatous polyposis (FAP) is a genetic disorder characterized by the early onset of hundreds of polyps in the gastrointestinal tract, mainly in the colon and rectum. Despite its rarity, data on FAP in Morocco remain limited due to the absence of a national registry and comparative case series.  \nWe present two cases ofFAP diagnosed in Morocco. The two patients, one male and one female, had a mean age of 34 years. Initial colonoscopy revealed more than 100 polyps for both patients. The polyps varied in size and morphology, including flat, sessile, and pedunculated forms, and were distributed throughout the colon and rectum, and all showed adenomatous features on virtual chromoendoscopy. Histopathological examination of the polyps revealed a range of findings, from low-grade tubulovillous adenomas to moderately differentiated rectal adenocarcinoma. Esophagogastroduodenoscopy (EGD) revealed duodenal polyps, with histology confirming tubular adenomas exhibiting both low-and high-grade dysplasia.  \nBoth patients underwent surgery: one had a subtotal colectomy with ileorectal anastomosis, and the other a total proctocolectomy with ileoanal anastomosis.  \nThe clinical evolution was marked by the development of colon adenocarcinoma in one patient and rectal adenocarcinoma in the other. Regular surveillance of the duodenal polyps was recommended every 1-2 years.  \nCategories: Pathology, Oncology, Gastroenterology  \nKeywords: bowel cancer screening, colorectal cancer, lower endoscopy, polyps, familial adenomatous polyposis  \nIntroduction  \nFamilial adenomatous polyposis (FAP) is a rare autosomal dominant genetic disorder characterized by the early onset of hundreds of polyps in the gastrointestinal tract, primarily in the colon and rectum, starting atan early age.  \nAlthough FAP represents only about 1% of colorectal cancers, it carries a high risk of early-onset malignancy without proper management [1] . Proper management includes regular endoscopic surveillance, timely surgical intervention (sometimes including prophylactic colectomy), follow-up for extra-colonic manifestations, and genetic counseling for patients and at-risk family members.  \nCaused by APC gene mutations that disrupt cell proliferation, FAP underscores the need for genetic testing. Yet, in 20% of cases, the causative mutation remains unidentified, complicating management [2] .  \nIn Morocco, where genetic diversity may affect disease presentation, careful diagnosis and targeted screening are crucial for at-risk individuals. Although FAP is uncommon, it is particularly challenging, especially in some countries, due to delayed diagnosis, limited access to genetic testing, the absence of a national colorectal cancer screening program, and patients often being lost to follow-up.  \nWe present two cases of FAP diagnosed and managed in this context, highlighting the diag","cbCailfojwcLCDFD","https://ap.wps.com/l/cbCailfojwcLCDFD","pdf",7548118,"English","# Abstract\n# Introduction\n# Case Presentation\n## Case 1\n## Case 2\n# Discussion\n# Conclusion","[{\"question\":\"What is familial adenomatous polyposis and why is it clinically important?\",\"answer\":\"FAP is a rare autosomal dominant genetic disorder causing early hundreds of polyps in the gastrointestinal tract, mainly the colon and rectum. It carries a high risk of early-onset malignancy without proper management.\"},{\"question\":\"What did colonoscopy and chromoendoscopy show in the two reported cases?\",\"answer\":\"Initial colonoscopy showed more than 100 polyps in both patients. The polyps varied in size and morphology across the colon and rectum and showed adenomatous features on virtual chromoendoscopy.\"},{\"question\":\"How were the patients managed and what surveillance was recommended?\",\"answer\":\"Both patients underwent surgery: one with subtotal colectomy and ileorectal anastomosis, the other with total proctocolectomy and ileoanal anastomosis. Regular surveillance of duodenal polyps was recommended every 1–2 years.\"}]","Challenging Aspects of Familial Adenomatous Polyposis With Malignant Transformation - A Report of Two Cases | PDF",1790759862,23]