Aggressive phenotype of MYH-associated polyposis with jejunal cancer and intra-abdominal desmoid tumor: report of a case.
MYH-associated polyposis is an inherited autosomal recessive disease, linked to biallelic germline MYH mutations, which predisposes to the development of multiple colorectal adenomas and cancer. The colonic and extracolonic phenotype of this syndrome is very heterogeneous. We report the case of a young male patient with an aggressive MYH-associated polyposis phenotype. He presented at aged 30 years with more than 100 colonic polyps and 4 colonic adenocarcinomas. At aged 35 years, Spigelman Stage IV duodenal adenomatosis was detected. When he was 39 years old, he developed three synchronous jejunal adenocarcinomas and a mesenteric desmoid tumor. Based on this report, we believe that screening of the entire small bowel should be recommended in MYH-associated polyposis patients, especially in those with duodenal adenomas. Similar to patients with familial adenomatous polyposis, desmoid tumors also may be part of the clinical spectrum of MYH-associated polyposis and may prove to be a significant clinical problem in patients submitted to prophylactic colectomy.
de Ferro
Susana Mão
SM
Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Gastrenterologia, Lisbon, Portugal. smaodeferro@gmail.com
Suspiro
Alexandra
A
Fidalgo
Paulo
P
Lage
Pedro
P
Rodrigues
Paula
P
Fragoso
Sofia
S
Vitoriano
Inês
I
Baltazar
Célia
C
Albuquerque
Cristina
C
Bettencourt
António
A
Leitão
Carlos Nobre
CN
D000230:Adenocarcinoma / Q000235:genetics; D000236:Adenoma / Q000235:genetics; D011125:Adenomatous Polyposis Coli / Q000235:genetics*; D000328:Adult; D015179:Colorectal Neoplasms / Q000235:genetics*; D045647:DNA Glycosylases / Q000235:genetics; D004379:Duodenal Neoplasms / Q000235:genetics; D018222:Desmoid Tumors / Q000235:genetics*; D020022:Genetic Predisposition to Disease; D018095:Germ-Line Mutation; D006801:Humans; D007414:Intestinal Neoplasms / Q000235:genetics; D007415:Intestinal Obstruction / Q000209:etiology; D007580:Jejunal Neoplasms / Q000150:complications / Q000235:genetics*; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008643:Mesentery; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000235:genetics*; D010534:Peritoneal Neoplasms / Q000235:genetics*; D010641:Phenotype; D013577:Syndrome
D045647:DNA Glycosylases