Hereditary flat adenoma syndrome (HFAS) is presently thought to be a variant of FAP, with the genetic defect linked to 5q21-22. Signs of HFAS are:
• Multiple colorectal adenomas, but usually fewer than 100
• Polyps tend to occur at a later age than in classic FAP
• Adenomas tend to show a proximal location
• Onset of colorectal cancer is later than in hereditary non-polyposis colorectal cancer (HNPCC) and FAP
• These individuals have adenomas and cancers of the stomach and duodenum
• Fundic gland polyps of the stomach are also noted In some patients fundic may be present in the absence of colorectal adenomas . Lynch stressed that only about 1% of such adenomas have highgrade dysplasia, which is much lower than reported in patients with sporadic flat adenoma .
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