Table 2.
Spiegelman Stage
| Duodenal adenomatosis staging system | |||
|---|---|---|---|
| Polyps | 1 Point | 2 Points | 3 Points |
| Number | < 4 | 5-20 | > 20 |
| Size | 0-4 mm | 5-10 mm | > 10 |
| Histology | Tubular | Tubulovilllous | Villious |
| Dysplasia | Mild | Moderate | Severe |
| Spiegelman Stage | Total Points | Frequency of Surveillance | |
| Recommended duodenal surveillance frequency | |||
| 0 | 0 | Every 4 years | |
| I | ≤4 | Every 2-3 years | |
| II | 5-6 | Every 1-3 years | |
| III | 7-8 | Every 6-12 years | |
| IV | 9-12 | Expert surveillance every 3-6 months | |
| Surgical evaluation | |||
| Complete mucosectomy or duodenectomy or Whipple procedure if duodenal papilla is involved | |||