Multistage Management of Splenic Flexure Adenocarcinoma in Suspected MUTYH-Associated Polyposis: A Case Report

Andrea Costanzi; Humberto Tapia Gomez; Giulia Schievano; Marco Chiarelli; Simone Olmetti; Alberto Scaini; David Bernasconi; Giulia Bonfanti; Ilaria Canfora; Noemi Bicelli; Francesca Carissimi; Nicola Fazzini; Giacomo Bonfanti; Richard Sassun

doi:10.62713/aic.4277

journal article Open Access Apr 10, 2026

Multistage Management of Splenic Flexure Adenocarcinoma in Suspected MUTYH-Associated Polyposis: A Case Report

Andrea Costanzi Humberto Tapia Gomez Giulia Schievano Marco Chiarelli Simone Olmetti Alberto Scaini David Bernasconi Giulia Bonfanti Ilaria Canfora Noemi Bicelli Francesca Carissimi Nicola Fazzini Giacomo Bonfanti Richard Sassun

Annali Italiani di Chirurgia Vol. 97 No. 4 · Annali Italiani di Chirurgia

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Abstract

AIM: Colorectal adenocarcinoma in young adults should prompt evaluation for hereditary syndromes such as familial adenomatous polyposis (FAP), attenuated FAP, MUTYH-associated polyposis (MAP) and other inherited cancer predisposition syndromes. The purpose of this case report is to highlight management options of incidental MAP diagnosis. CASE PRESENTATION: We report the case of a 41-year-old man presenting to the emergency department with intestinal obstruction due to adenocarcinoma of the splenic flexure, colonic polyposis with rectal sparing, and a significant family history of cancer. RESULTS: After successful endoscopic stenting, a multidisciplinary approach including surgical resection, adjuvant treatment and genetic counseling was carried out. CONCLUSIONS: A minimally invasive subtotal colectomy was proposed to a 41-year-old man whose genetic testing for polyposis and hereditary cancer syndromes revealed a rare homozygotic variation of uncertain significance (VUS)+ in the MUTYH gene. Absence of rectal involvement made rectal sparing possible in association with close endoscopic follow-up.

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Published: Apr 10, 2026
Vol/Issue: 97(4)
License: View

Authors

A

Andrea Costanzi

General Surgery Residency Program, University of Milan, 20122 Milano, Italy; General Surgery Unit, San Leopoldo Mandic Hospital, ASST Lecco, 23807 Merate, Italy

H

Humberto Tapia Gomez

General Surgery Residency Program, University of Milan, 20122 Milano, Italy

G

Giulia Schievano

General Surgery Residency Program, University of Milan, 20122 Milano, Italy

M

Marco Chiarelli