A 39-year-old man with a family history of early onset colon cancer in multiple relatives underwent colonoscopy. This large polypoid lesion was found in the cecum and biopsied. The family was identified as having hereditary non-polyposis colon cancer syndrome (HNPCC, Lynch syndrome).
The patient underwent subtotal colectomy (see total colectomy and J-pouch). Abdominal exploration was unremarkable except for the cecal lesion. The distal sigmoid was divided, leaving a short colon segment distally for easy endoscopic surveillance.
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