Attenuated FamilialAdenomatous Polyposis (AFAP) is a heritable autosomally dominant syndrome, withlater diagnosis than the classical condition of Familial Adenomatous Polyposis.Amid its main features there are : a) the presence of less than 100 polyps;b) the mild course of the disease and its later diagnosis and development ofcolon cancer; c)the polyps are more frequent in the right colon; d)the rectummay be relatively or even totally spared. To analyze the clinical manifestations,treatment and follow-up of 13 patients with AFAP. The mean age was 55 years,five patients had positive family history of polyposis and/or colon cancer andnine (69%) patients had already developed colonic cancer at the time of thediagnosis. Most of the patients had polyps located in the right colon. Six outof 13 patients patients had undergone surgical resection, either proctocolectomyor colectomy. The average follow-up time was 26 months. Periodically colonoscopyor retosigmoidoscopy were employed for follow-up evaluation, according to theprevious surgical procedure. The diagnosis of AFAP was made later than the oneof the classic form of the disease and most of the polyps were located in theright colon. Frequent follow-up with endoscopic examination as a follow-up ismandatory. Colectomy with ileo-rectal anastomosis is a very good option in thesurgical management of these patients with low recurrence rate of rectal polyps.
