Which of the following conditions is associated with numerous adenomatous polyps and a risk of malignant transformation?

Familial Polyposis, specifically referencing Familial Adenomatous Polyposis (FAP), is indeed characterized by the development of numerous adenomatous polyps in the colon and rectum. Individuals with FAP typically develop hundreds to thousands of polyps, often starting in their teenage years. If these polyps are left untreated, there is a near 100% risk of malignant transformation into colorectal cancer by the age of 40 to 50.

The association with adenomatous polyps is critical here as these types of polyps are known precursors to colorectal cancer. FAP is an autosomal dominant disorder caused by mutations in the APC gene, which is a tumor suppressor gene. The presence of multiple polyps necessitates surveillance and often surgical intervention, such as colectomy, to prevent cancer.

In contrast, Gardner Syndrome, a variant of FAP, also features adenomatous polyps but additionally includes extraintestinal manifestations like osteomas and soft tissue tumors. Turcot Syndrome combines central nervous system tumors with polyps, while Peutz-Jeghers Syndrome is characterized by hamartomatous polyps and non-polyp related cancer risks, notably involving other organ systems, rather than extensive adenomatous polyps specifically leading