title: Cowden Syndrome: Case Report, Update and Proposed Diagnostic and Surveillance Routines.
abstract: Cowden syndrome (CS) is an infrequent autosomal dominant multisystem genodermatosis, generally involving the skin, oral mucosa, thyroid, breast and gastrointestinal tract. It is characterized by a late onset in the 2(nd) or 3(rd) decade of life, an extraordinary potential for malignant transformation, especially of breast and thyroid, and an identifiable germline mutation. In 80% cases, the human tumor suppressor gene, phosphatase and tensin homolog (PTEN) is mutated; mutations involving KILLIN, SDH B/D, PIK3CA and AKT1 genes account for the rest of the cases. Its clinical signs are not only the "essential pearls" for early and accurate diagnosis of CS but also help timely detection of neoplasia as they precede development of cancer by several years. We describe the first Indian and the third world report of polydactyly with CS, review this entity highlighting on recent clinical developments and emphasize on regular and thorough screening for prompt identification and management of the potentially malignant growths. We have also designed a baseline workup routine as well as a detailed screening program for these patients.
authors.affiliation: Department of Dermatology, Venereology and Leprology, Padmashree Dr. D.Y. Patil Medical College and Hospital, Pune, India.
authors.forename: Masuma
authors.initials: M
authors.lastname: Molvi
authors.affiliation: Department of Dermatology, Venereology and Leprology, Padmashree Dr. D.Y. Patil Medical College and Hospital, Pune, India.
authors.forename: Yugal K
authors.initials: YK
authors.lastname: Sharma
authors.affiliation: Department of Dermatology, Venereology and Leprology, Padmashree Dr. D.Y. Patil Medical College and Hospital, Pune, India.
authors.forename: Kedarnath
authors.initials: K
authors.lastname: Dash
keywords: Genodermatosis; KLLN (Killin); hereditary cancer predisposition syndrome; multiple hamartoma syndrome; phosphatase and tensin homolog