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עמוד בית
Fri, 05.12.25

CASE COMMUNICATIONS

IMAJ | volume 27

Journal 7, July 2025
pages: 456-458

Rectal Adenocarcinoma in Juvenile Polyposis Syndrome: Insights from Two Case Reports

1 Department of General Surgery, Rambam Health Care Campus, Haifa, Israel 2 Department of Pediatrics B, Rambam Health Care Campus, Haifa, Israel 3 Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel

Summary

Juvenile polyposis syndrome (JPS) is a rare autosomal dominant disorder characterized by hamartomatous polyps throughout the gastrointestinal tract, with an estimated prevalence of 1 in 100,000 individuals. While most cases follow an autosomal dominant inheritance pattern, some are caused by de novo mutations [1].

The age of onset for JPS is typically during childhood or adolescence, with a mean age at diagnosis of 18.5 years [2]. A major concern in JPS is the increased risk of colorectal cancer (CRC), requiring close lifelong surveillance. The cumulative lifetime risk for CRC ranges from 38% to 68%, with a mean age at diagnosis between 34 and 44 years [3].

Although juvenile polyps were initially considered to have low malignant potential, studies have identified two pathways of carcinogenesis in JPS: progression from hamartomatous polyps to adenoma and then to adenocarcinoma or direct transformation of hamartomatous polyps into adenocarcinoma. The management of JPS is tailored to each patient's specific manifestations and clinical presentation. The primary treatment goal is to prevent morbidity associated with gastrointestinal polyps, such as bleeding and intestinal obstruction.

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