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Büki G, Antal G, Bene J. Rare Germline Variants in the Adenomatous Polyposis Coli Gene Associated with Dental and Osseous Anomalies. Int J Mol Sci 2024; 25:8189. [PMID: 39125758 PMCID: PMC11312143 DOI: 10.3390/ijms25158189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
APC is a tumor suppressor gene that exerts its effect through the regulation of the Wnt signaling pathway. Loss of function mutations of the gene are associated with familial adenomatous polyposis (FAP). Early diagnosis in FAP patients is essential to prevent the development of colorectal cancer. Extraintestinal manifestations often precede the formation of the polyposis; therefore, these manifestations may serve as a clinical indicator for the condition. The aim of this study was to assess genotype-phenotype associations between the location of APC mutations and various extraintestinal features, mainly focusing on osseous and dental anomalies. Analyses of our cases and the mutations available in the literature with these manifestations revealed that mutations in the N-terminal region (amino acids 1-~1000) of the protein are more frequently associated with only osseous anomalies, whereas dental manifestations are more prevalent in mutations in the middle region (amino acids 1000-~2100). In addition, supernumerary teeth were found to be the most common dental feature. Since dental abnormalities often precede intestinal polyposis, dentists have a crucial role in the early identification of patients at risk.
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Affiliation(s)
- Gergely Büki
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary;
| | - Gréta Antal
- Department of Dentistry, Oral and Maxillofacial Surgery, Clinical Center, Medical School, University of Pécs, 7623 Pécs, Hungary;
| | - Judit Bene
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary;
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Arruda KAR, Normando AGC, Pacheco-Pereira C, Amorim Dos Santos J, Yamaguti PM, Mazzeu JF, Almeida FT, Acevedo AC, Guerra ENS. Phenotypic dento-osseous characterization of a Brazilian family with Familial Adenomatous Polyposis. Arch Oral Biol 2021; 129:105206. [PMID: 34224960 DOI: 10.1016/j.archoralbio.2021.105206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/17/2021] [Accepted: 06/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To perform a phenotypic characterization of the dento-osseous anomalies in a Brazilian family with Familial Adenomatous Polyposis (FAP) and to investigate the adenomatous polyposis coli (APC) causative variant. DESIGN The study included a family of 14 individuals (Group A: affected; Group B: non-affected). The frequency of radiographic findings in both groups was evaluated according to the Dental Panoramic Radiograph Score (DPRS) diagnostic method. The accuracy and reproducibility of DPRS were tested. The DNA was isolated from the index patient's saliva and submitted to whole-exome and Sanger sequencing approach. RESULTS DPRS ≥ 7 was observed in 80 % of Group A but in none of Group B. The most common findings in Group A were dense bone islands (60 %), hazy sclerosis (40 %), osteomas (40 %), and supernumerary tooth (20 %). DPRS has proved to be a reliable method while DPRS ≥ 5 and DPRS ≥ 7 were taken as positive for FAP, and reproducible diagnosis test considering that the evaluators correctly identified the affected patients (Kappa agreement>0.8, p = 0.002). A nonsense heterozygous mutation in the APC gene (c.1370C > G; p.Ser457*) of the index case was detected. CONCLUSION FAP patients have a higher frequency of dento-osseous anomalies (p = 0.005). Bone abnormalities were more prevalent than dental anomalies (p = 0.001). Thus, FAP patients should be referred for dental examination and genetic counseling to perform early diagnosis of dento-osseous anomalies and evaluate the implications of the molecular findings in each particular family.
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Affiliation(s)
- Karen Ariely Rocha Arruda
- Laboratory of Oral Histopathology, Health Sciences Faculty and Oral Care Center for Inherited Diseases, University of Brasilia, Brasília, Brazil
| | - Ana Gabriela Costa Normando
- Laboratory of Oral Histopathology, Health Sciences Faculty and Oral Care Center for Inherited Diseases, University of Brasilia, Brasília, Brazil
| | - Camila Pacheco-Pereira
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Juliana Amorim Dos Santos
- Laboratory of Oral Histopathology, Health Sciences Faculty and Oral Care Center for Inherited Diseases, University of Brasilia, Brasília, Brazil
| | - Paulo Marcio Yamaguti
- Laboratory of Oral Histopathology, Health Sciences Faculty and Oral Care Center for Inherited Diseases, University of Brasilia, Brasília, Brazil
| | - Juliana Forte Mazzeu
- Laboratory of Clinical Genetics, Faculty of Medicine, University of Brasilia, Brasilia, Brazil
| | | | - Ana Carolina Acevedo
- Laboratory of Oral Histopathology, Health Sciences Faculty and Oral Care Center for Inherited Diseases, University of Brasilia, Brasília, Brazil
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty and Oral Care Center for Inherited Diseases, University of Brasilia, Brasília, Brazil.
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3
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Almeida FT, Pachêco-Pereira C, Porporatti AL, Flores-Mir C, Leite AF, De Luca Canto G, Guerra ENS. Oral manifestations in patients with familial adenomatous polyposis: A systematic review and meta-analysis. J Gastroenterol Hepatol 2016; 31:527-40. [PMID: 26331960 DOI: 10.1111/jgh.13149] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/17/2015] [Accepted: 08/21/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM The oral manifestations of familial adenomatous polyposis (FAP) have been reported in the recent literature. Therefore, there has been growing interest in the characterization of the dento-osseous anomalies because they may precede colorectal cancer and may be used as a diagnostic marker. This systematic review and meta-analysis was performed to evaluate the published evidence for what are the oral manifestations of FAP and their frequency in affected individuals. METHODS The search was performed at Cochrane Library, EMBASE, LILACS, PubMed, Scopus, and Web of Science for articles published up to March 2015. A grey literature search was conducted through Google Scholar. Reference lists of the included articles and additional studies identified by expert were screened for potential relevant studies. The methodology of selected studies was evaluated using the risk of bias checklist of the Agency for Healthcare Research and Quality. RESULTS Twenty observational studies totalizing 1635 individuals affected by FAP met the inclusion criteria. Osseous, dental, and oral mucosa alterations were observed in FAP patients. The meta-analysis showed the frequency of osseous jaw lesions, and the dental anomalies were 65.35% and 30.48%, respectively, and two studies suggested that oral mucosa vascular density is a phenotypic manifestation in patients with FAP. Most of the studies were evaluated as moderate risk of bias. CONCLUSION The most frequent oral manifestation on FAP patients is osseous jaw alterations. In the future, well-designed studies are necessary to classify osseous and dental anomalies in order to demonstrate the true prevalence of each alteration separately.
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Affiliation(s)
| | - Camila Pachêco-Pereira
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta,, Canada
| | - André Luís Porporatti
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil.,Department of Prosthodontics, Section of Orofacial Pain, Bauru School of Dentistry, University of São Paulo, Bauru, SP,, Brazil
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta,, Canada
| | - André Ferreira Leite
- Oral Histopathology Laboratory, Health Sciences Faculty, University of Brasília, Brasília, Brazil
| | - Graziela De Luca Canto
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta,, Canada.,Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
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4
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Wijn MA, Keller JJ, Giardiello FM, Brand HS. Oral and maxillofacial manifestations of familial adenomatous polyposis. Oral Dis 2007; 13:360-5. [PMID: 17577321 DOI: 10.1111/j.1601-0825.2006.01293.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patients with familial adenomatous polyposis (FAP) develop multiple premalignant colorectal adenomas. Untreated, one or more of these polyps will progress to colorectal carcinoma in middle-aged adults. Extra-intestinal manifestations of FAP are frequently observed and this combination has been called Gardner's syndrome. Oral and maxillofacial symptoms of FAP include an increased risk of jaw osteomas, odontomas and supernumerary or unerupted teeth. Early diagnosis of FAP is crucial and may be life saving. As oral signs usually precede gastrointestinal symptoms, the dentist may play an important role in the diagnosis of FAP.
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Affiliation(s)
- M A Wijn
- Departments of Oral-Maxillofacial Surgery and Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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5
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Smud D, Augustin G, Kekez T, Kinda E, Majerovic M, Jelincic Z. Gardner's syndrome: Genetic testing and colonoscopy are indicated in adolescents and young adults with cranial osteomas: A case report. World J Gastroenterol 2007; 13:3900-3. [PMID: 17657852 PMCID: PMC4611230 DOI: 10.3748/wjg.v13.i28.3900] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We present a case of a 25-year-old female with diagnosed familial adenomatous polyposis and elevated carcinoembryonic antigen with negative family history. The suspicion of Gardner's syndrome was raised because extirpation of an osteoma of the left temporo-occipital region was made 10 years ago. Restorative procto-colectomy and ileal pouch anal anastomosis was made but histology delineated adenocarcinoma of the rectum (Dukes C stage). We conclude that cranial osteomas often precede gastrointestinal manifestations of familial adenomatous polyposis or Gardner's syndrome and such patients should be evaluated with genetic testing followed by colonoscopy if results are positive to prevent the development of colorectal carcinoma. If the diagnosis is positive all family members should be evaluated for familial adenomatous polyposis.
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Affiliation(s)
- Dubravko Smud
- Clinical Hospital Center Zagreb, Department of Surgery, Division of Abdominal Surgery, Kispaticeva 12, Zagreb 10000, Croatia
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Affiliation(s)
- Anders Merg
- Roswell Park Cancer Center, Buffalo, New York, USA
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7
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Lowichik A, Jackson WD, Coffin CM. Gastrointestinal polyposis in childhood: clinicopathologic and genetic features. Pediatr Dev Pathol 2003; 6:371-91. [PMID: 14708731 DOI: 10.1007/s10024-002-0701-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Gastrointestinal polyps and certain extraintestinal lesions in children may herald a hereditary polyposis syndrome, with an increased risk of neoplasia and other health problems for both children and their relatives. The availability of molecular/genetic screening tests has increased early diagnosis of younger members of known polyposis families. This article reviews the gross and microscopic features of polyposis syndromes of childhood and summarizes the molecular/genetic advances in this field. Clinical management is also briefly discussed.
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Affiliation(s)
- Amy Lowichik
- Department of Pathology, University of Utah Health Sciences Center, 30 N. 1900 E, Salt Lake City, UT 84132-2501, USA.
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8
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Mafee MF, Yang G, Tseng A, Keiler L, Andrus K. Fibro-osseous and giant cell lesions, including brown tumor of the mandible, maxilla, and other craniofacial bones. Neuroimaging Clin N Am 2003; 13:525-40. [PMID: 14631689 DOI: 10.1016/s1052-5149(03)00040-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Fibro-osseous, osseous, cartilaginous, and giant cell lesions of the mandible, maxilla, and other craniofacial bones share overlapping clinical, radiologic, and pathologic features that may lead to diagnostic confusion and possible misdiagnosis. The value of combined clinical-radiologic-pathologic correlation in the diagnosis of these lesions is paramount to achieving the correct diagnosis with subsequent implementation of appropriate therapeutic intervention.
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Affiliation(s)
- Mahmood F Mafee
- Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA.
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Aggarwal VR, Sloan P, Horner K, Macfarlane TV, Clancy T, Evans G, Thakker N. Dento-osseous changes as diagnostic markers in familial adenomatous polyposis families. Oral Dis 2003; 9:29-33. [PMID: 12617255 DOI: 10.1034/j.1601-0825.2003.00894.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND We have previously described a weighted index for determining the diagnostic significance of dento-osseous changes observed on dental panoramic radiographs (DPRs) in individuals at 50% risk of inheriting Familial Adenomatous Polyposis (FAP). A diagnostic test based on this index (Dental Panoramic Radiograph Score, DPRS) was shown to have a sensitivity of 69% and specificity of 100%. OBJECTIVES To evaluate the validity of the diagnostic test in an independent sample of individuals at 50% risk of inheriting FAP. DESIGN A retrospective assessment of DPRs in individuals at 50% risk of inheriting FAP. SUBJECTS AND METHODS A final year dental student assessed blindly and independently, DPRs from an independent sample (n = 119) of affected (n = 26), unaffected (n = 78) and clinically low risk individuals (n = 15). This revealed a sensitivity and specificity of 62 and 97% respectively which is in close agreement with results of the previous study. The dental student's training in assessing DPRs was previously tested using radiographs from 81 individuals from our original study. Weighted Kappa statistics were used to test for agreement. A kappa score of 0.82 (95% confidence interval 0.70-0.93) indicated almost perfect agreement. MAIN OUTCOME The DPRS is a reproducible and valid index for assessing the diagnostic significance of dentoosseous changes, in individuals at 50% risk of FAP, even in relatively inexperienced hands.
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Affiliation(s)
- V R Aggarwal
- Depariment of Dental Medicine and Surgery, University of Manchester, UK.
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10
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Abstract
Remarkable progress has been accomplished in understanding the molecular basis of genetic colon cancer syndromes including FAP and HNPCC, and their variants; of sporadic colon cancer; and of the rare hamartomatous polyp syndromes. This molecular progress now has to be translated into clinical progress in molecular diagnosis, and in pharmacologic therapy for colonic polyps and cancers. It is hoped that such progress will impact on the frequency and mortality of this very common and frequently fatal cancer.
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Affiliation(s)
- David H Robbins
- Dr. Henry D. Janowitz Division of Gastroenterology, Box 1069, Mount Sinai School of Medicine, One Gustave Levy Place, New York, NY 10029, USA
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11
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Reyes J, Llompart A, Barranco L, Gayà J, Forteza-Rey I, Obrador A. [Osteomatous jaw lesions in familial adenomatous polyposis]. GASTROENTEROLOGIA Y HEPATOLOGIA 2002; 25:387-91. [PMID: 12069700 DOI: 10.1016/s0210-5705(02)70271-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The first aim of this study is to assess the frequency of osteomatous jaw lesions in patients with a diagnosis of familial adenomatous polyposis (FAP), and a group of FAP-relatives from the FAP registry of Majorca (Balearic Islands, Spain). The second aim is to study the predictive significance of osteomatous jaw lesions in families with FAP. The study included forty-two people. Twenty-five patients and seventeen relatives. All individuals underwent pantomography. Osteomatous jaw lesions were diagnosed in 68% of FAP-patients, and 6% of FAP-relatives. The difference was statistically significant (p < 0.001). The sensitivity was 68%, the specificity 94% and positive predictive value 94%. This frequency of osteomatous jaw lesions agree with previous studies of FAP-patients (57-82%), but differ from these of the previous studies of FAP-relatives (16-18%). The available method detect APC (adenomatous polyposis coli) gene mutations in 48-82% of FAP families. In the families without detected mutation, non-informative study or non-available study, the screening is based in seriated sigmoidoscopy and study of the extraintestinals lesions of the FAP syndrome. The frequency of osteomatous jaw lesions in FAP-patients is greater than the observed in FAP-relatives (p < 0.001). Osteomas in families with FAP are of predictive significance.
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Affiliation(s)
- J Reyes
- Servicio de Digestivo, Hospital Son Dureta, Palma, Mallorca, Spain
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12
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Shibata D, Aaltonen LA. Genetic predisposition and somatic diversification in tumor development and progression. Adv Cancer Res 2001; 80:83-114. [PMID: 11034541 DOI: 10.1016/s0065-230x(01)80013-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Studies on human cancer predisposition syndromes have contributed significantly to our understanding on tumor initiation and progression. Work performed on hereditary colon cancer has been particularly fruitful. Much of the molecular background of the various intestinal polyposis syndromes, such as familial adenomatous polyposis (FAP), juvenile polyposis, and Peutz-Jeghers syndrome, has been revealed, pinpointing several key cancer-associated genes. Studies on hereditary nonpolyposis colorectal cancer (HNPCC) have revealed a novel mechanism of tumorigenesis; genomic instability caused by defective DNA mismatch repair (MMR). Understanding the molecular background of these diseases helps us to understand tumor initiation in the affected individuals. Relatively little is known about the details of tumor progression in hereditary and sporadic neoplasia. Certain additional gene mutations can be associated with advancing stages of the disease, but the pace and tempo of the process have remained obscure. A high mutation rate in MMR-deficient tumors has provided a new approach in the analysis of human tumor dynamics. Microsatellite (MS) sequences are frequently mutated in MMR deficient tumors. The high mutation rate allows the use of microsatellite mutations as a tool for analyzing the past patterns of tumor progression. This approach is similar to the use of MS mutations in studying human evolution and migrations. Such tumor studies have revealed progression pathways that differ from the classic adenoma-cancer sequence. The reasons why and how molecular clocks may reveal something new about a well-studied problem are discussed.
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Affiliation(s)
- D Shibata
- Department of Pathology, Norris Cancer Center, University of Southern California School of Medicine, Los Angeles 90033, USA
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13
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Abstract
Mechanisms involved in hereditary intestinal cancer are likely to play a role in sporadic tumorigenesis as well. Studies focusing on the molecular biology underlying these syndromes has contributed considerably to our knowledge on molecular bases of malignant transformation. It can be concluded, that there are two aspects to the importance of studies on intestinal cancer predisposition. First, the families suffering from cancer proneness need help which can, to some extent, be provided through molecular genetic studies. Second, the resources appointed to such research have produced scientific advances with outstanding importance to our understanding of common malignant diseases.
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Affiliation(s)
- L A Aaltonen
- Department of Medical Genetics, University of Helsinki, P.O. Box 21, FIN-00014, Finland
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14
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Wenig BM, Mafee MF, Ghosh L. Fibro-osseous, osseous, and cartilaginous lesions of the orbit and paraorbital region. Correlative clinicopathologic and radiographic features, including the diagnostic role of CT and MR imaging. Radiol Clin North Am 1998; 36:1241-59, xii. [PMID: 9884700 DOI: 10.1016/s0033-8389(05)70243-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Fibro-osseous and cartilaginous lesions of the orbit and facial region share overlapping clinical, radiologic, and pathologic features that may lead to diagnostic confusion and possible misdiagnosis. The value of imaging studies in the histopathologic diagnosis of these lesions cannot be overemphasized. The histopathologic diagnosis of such lesions should not be rendered in the absence of radiographic correlation.
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MESH Headings
- Cartilage Diseases/diagnosis
- Cartilage Diseases/diagnostic imaging
- Cartilage Diseases/pathology
- Diagnosis, Differential
- Fibrous Dysplasia of Bone/diagnosis
- Fibrous Dysplasia of Bone/diagnostic imaging
- Fibrous Dysplasia of Bone/pathology
- Giant Cell Tumor of Bone/diagnosis
- Giant Cell Tumor of Bone/diagnostic imaging
- Giant Cell Tumor of Bone/pathology
- Granuloma, Giant Cell/diagnosis
- Granuloma, Giant Cell/diagnostic imaging
- Granuloma, Giant Cell/pathology
- Humans
- Magnetic Resonance Imaging
- Neoplasms, Bone Tissue/diagnosis
- Neoplasms, Bone Tissue/diagnostic imaging
- Neoplasms, Bone Tissue/pathology
- Neoplasms, Connective Tissue/diagnosis
- Neoplasms, Connective Tissue/diagnostic imaging
- Neoplasms, Connective Tissue/pathology
- Orbital Diseases/diagnosis
- Orbital Diseases/diagnostic imaging
- Orbital Diseases/pathology
- Orbital Neoplasms/diagnosis
- Orbital Neoplasms/diagnostic imaging
- Orbital Neoplasms/pathology
- Tomography, X-Ray Computed
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Affiliation(s)
- B M Wenig
- Department of Endocrine and Otorhinolaryngic-Head and Neck Pathology, Armed Forces Institute of Pathology, Washington, DC, USA
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Abstract
OBJECTIVE AND IMPORTANCE We report a unique case of ivory osteoma of the cervical spine. CLINICAL PRESENTATION The clinical presentation was one of polyradicular deficit without myelopathy after trauma. The imaging characteristics and histology of the lesion were those of a classic ivory osteoma. INTERVENTION A complete surgical excision of the lesion was accomplished. CONCLUSION We think we have recorded the only well-documented case of ivory osteoma affecting the spine.
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Affiliation(s)
- S S Rengachary
- Department of Neurosurgery, University of Minnesota Hospital and Clinics, Minneapolis, USA
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Dunlop MG, Farrington SM, Bubb VJ, Cunningham C, Wright M, Curtis LJ, Butt ZA, Wright E, Fleck BW, Redhead D, Mitchell R, Rainey JB, Macintyre IM, Carter DC, Wyllie AH. Extracolonic features of familial adenomatous polyposis in patients with sporadic colorectal cancer. Br J Cancer 1996; 74:1789-95. [PMID: 8956794 PMCID: PMC2077219 DOI: 10.1038/bjc.1996.631] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
We have investigated the occurrence of attenuated extracolonic manifestations (AEMs) of familial adenomatous polyposis (FAP) in patients with non-polyposis colorectal cancer. In a prospective case-control study, we observed that significantly more colorectal cancer patients exhibited AEM than did age and sex-matched controls (19.5% vs 7.5%, P < 0.004). However patients with AEMs do not have occult FAP, as we found no heterozygous adenomatous polyposis coli (APC) gene mutations despite extensive analysis of constitutional DNA. Genome-wide DNA replication errors (RERs) occur in a proportion of colorectal cancers, particularly right-sided lesions and in almost all tumours from hereditary non-polyposis colorectal cancer (HNPCC) patients. As AEMs have been reported in familial colon cancer cases, we investigated the relationship of AEMs to tumour RER phenotype. There was indeed an excess of AEMs in patients with right-sided tumours (30.2% of 53 patients vs 14.7% of 116 patients, P < 0.03) and in those with RER tumours (3 out of 12 patients with RER tumours vs none out of 21 patients with non-RER tumours, P < 0.05). Two patients with AEM were from HNPCC families compared with none of those without AEM (P < 0.05). The association of AEMs with colorectal cancer is intriguing, and we speculate that it may be a manifestation of mutational mosaicism of the APC gene, perhaps associated with a constitutional defect in DNA mismatch pair.
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Affiliation(s)
- M G Dunlop
- University of Edinburgh, Department of Clinical Surgery, Royal Infirmary, UK
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Thakker NS, Evans DG, Horner K, Davies DR, Armstrong J, Guy S, Harris R, Sloan P. Florid oral manifestations in an atypical familial adenomatous polyposis family with late presentation of colorectal polyps. J Oral Pathol Med 1996; 25:459-62. [PMID: 8930826 DOI: 10.1111/j.1600-0714.1996.tb00297.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Early identification and prophylactic surgery are essential in preventing development of malignancy in colorectal polyps in familial adenomatous polyposis (FAP). Previous studies indicate a 100% cumulative risk of developing colonic polyps in individuals with FAP by the age of 34 yr. However, we have previously reported late-onset and non-penetrance of polyposis in four families. We describe here in detail one of these families with florid oral manifestations detectable on panoramic radiography of the jaws, which were instrumental in the diagnosis of FAP in the index patient and for ascertainment of her family for screening. The pathological adenomatous polyposis coli (APC) gene mutation in this family was shown to segregate with dento-osseous changes. Panoramic jaw radiography is a common examination carried out prior to dental or oral surgical procedures. This case illustrates the importance of appropriate investigations, including family history and colonoscopy, even in relatively older patients with radiological findings such as those described here and in members of their families at risk of FAP.
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Affiliation(s)
- N S Thakker
- Department of Medical Genetics, Central Manchester Healthcare Trust, St. Mary's Hospital, Manchester, UK
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18
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Thakker N, Davies R, Horner K, Armstrong J, Clancy T, Guy S, Harris R, Sloan P, Evans G. The dental phenotype in familial adenomatous polyposis: diagnostic application of a weighted scoring system for changes on dental panoramic radiographs. J Med Genet 1995; 32:458-64. [PMID: 7666398 PMCID: PMC1050486 DOI: 10.1136/jmg.32.6.458] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A weighted scoring system (Dental Panoramic Radiograph Score) taking into consideration the nature, extent, and site of osseous and dental changes on dental panoramic radiographs in familial adenomatous polyposis is described. The weighting takes into consideration the incidence of the anomaly in the general population. The reliability of the system was tested by application to 85 people known to be affected by clinical or mutation analysis, 30 people lacking mutation in the adenomatous polyposis gene, and 19 people shown to be at low risk (< 1%) by linkage analysis. Using the highest thresholds, a specificity of 100% and sensitivity of approximately 68% was obtained. If all positive findings were considered as significant, sensitivity was increased to approximately 82% but the specificity was reduced to approximately 88%. Significant DPRS findings were observed at a significantly higher frequency in patients aged over 20 compared to the patients aged 20 and under. Overall, approximately 68% of the affected subjects had significant changes, and approximately 18% had normal appearance on DPR, with the remainder having changes classified as minimal or equivocal.
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Affiliation(s)
- N Thakker
- Department of Medical Genetics, St Mary's Hospital, Manchester, UK
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Hartvigsen A, Myrhøj T, Bülow S, Børme KK, Søndergaard JO, Højgaard-Olsen K, Bernstein I. Ophthalmoscopy for congenital hypertrophy of the retinal pigment epithelium (CHRPE) in patients with sporadic colorectal carcinoma. Int J Colorectal Dis 1995; 10:138-9. [PMID: 7561429 DOI: 10.1007/bf00298534] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In order to investigate the frequency of congenital hypertrophy of the retinal pigment epithelium (CHRPE) in sporadic colorectal cancer, ophthalmoscopy was carried out in 34 patients with colorectal carcinoma without known familial disposition. CHRPE is one of the most frequent extracolonic manifestations in familial adenomatous polyposis. None of the patients showed any sign of CHRPE. It is concluded that although genetic factors are presumably of importance in the development of sporadic colorectal cancer, CHRPE cannot be used as a marker for future risk of colorectal carcinoma except in polyposis families.
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Affiliation(s)
- A Hartvigsen
- Department of Surgical Gastroenterology and of Ophthalmology, Hvidovre Hospital, University of Copenhagen, Denmark
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20
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Affiliation(s)
- A K Rustgi
- Gastrointestinal Unit, Massachusetts General Hospital, Boston 02114
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21
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Abstract
Familial adenomatous polyposis (FAP) is an autosomal dominant condition resulting in the development of more than 100 adenomatous polyps in the large bowel. In addition, a number of extracolonic manifestations of the condition may occur. Recently, increasing knowledge relating to the extracolonic abnormalities, and localization and sequencing of the gene for FAP, have had important implications for screening and long-term follow-up of those affected. In this review the natural history of the disease and the extracolonic manifestations associated with it are considered. Surgical management and advances in understanding at a molecular level are discussed, as well as the problems relating to screening for FAP and the implications of the new knowledge.
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Affiliation(s)
- W J Campbell
- University Department of Surgery, Belfast City Hospital, UK
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22
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Hunt LM, Robinson MH, Hugkulstone CE, Clarke B, Vernon SA, Gregson RH, Hardcastle JD, Armitage NC. Congenital hypertrophy of the retinal pigment epithelium and mandibular osteomata as markers in familial colorectal cancer. Br J Cancer 1994; 70:173-6. [PMID: 8018532 PMCID: PMC2033331 DOI: 10.1038/bjc.1994.271] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Congenital hypertrophy of the retinal pigment epithelium (CHRPE) and multiple mandibular osteomata are markers of familial adenomatous polyposis (FAP). We have assessed their prevalence in non-polyposis familial colorectal neoplasia. Multiple mandibular osteomata were present in 1/29 (3%) patients with familial colorectal neoplasia. CHRPE was present in 11/33 (33%) patients with familial colorectal neoplasia compared with 3/36 (8%) with sporadic disease (P = 0.01) and 4/32 (12.5%) control subjects (P = 0.04). Seven patients with familial colorectal neoplasia had multiple areas of CHRPE compared with one with sporadic disease (P = 0.02) and one control subject (P = 0.02). There was no obvious correlation between calculated familial colorectal cancer risk and the presence of multiple areas of CHRPE. A proportion of patients with familial colorectal cancer have a marker found in FAP and may therefore have a constitutional genetic defect, at least in part responsible for their cancer, making them an interesting group for genetic study. Ophthalmoscopy may contribute to risk assessment in familial colorectal cancer.
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Affiliation(s)
- L M Hunt
- Department of Surgery, University of Nottingham, Queen's Medical Centre, UK
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23
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Takeuchi T, Takenoshita Y, Kubo K, Iida M. Natural course of jaw lesions in patients with familial adenomatosis coli (Gardner's syndrome). Int J Oral Maxillofac Surg 1993; 22:226-30. [PMID: 8409564 DOI: 10.1016/s0901-5027(05)80641-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Twenty-three patients suffering from familial adenomatosis coli (FAC) were followed for an average of 7 years (0.11-16.11 years). In 22 patients, jaw lesions including osteomas and/or odontomas were present at the first examination. In 12 patients, some changes occurred; that is, the number and size of the lesions increased. These findings indicate that changes of jaw lesions in FAC patients occur gradually even in adulthood.
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Affiliation(s)
- T Takeuchi
- Second Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kyushu University, Fukuoka, Japan
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24
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Kaffe I, Rozen P, Horowitz I. The significance of idiopathic osteosclerosis found in panoramic radiographs of sporadic colorectal neoplasia patients and their relatives. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1992; 74:366-70. [PMID: 1408001 DOI: 10.1016/0030-4220(92)90077-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Osteosclerotic lesions in the mandible are reported with increased frequency in patients with colorectal neoplasia. Panoramic radiography has been suggested to detect high-risk patients among relatives of patients with hereditary adenomatous disease and sporadic colorectal cancer. The present study was undertaken to compare the incidence of idiopathic osteosclerotic lesions in patients with sporadic colorectal cancer and their first-degree relatives with the incidence in the general population and to determine whether panoramic radiographs are a reliable method to screen for early detection of risk of colorectal cancer. A total of 283 patients were interviewed and radiographically examined. Idiopathic osteosclerosis appeared in significantly increased incidence only in patients with colorectal cancer or adenomas and a first-degree relative with CRC (chi 2 = 7.214; p less than 0.01, and chi 2 = 4.1827; p less than 0.05 respectively). The incidence was not increased in first-degree relatives of patients with colorectal cancer or adenoma. Therefore panoramic radiographs cannot be the only screening tool for early detection of patients at high risk of colorectal cancer.
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Affiliation(s)
- I Kaffe
- Section of Oral Pathology and Oral Medicine, Maurice and Gabriela School of Dental Medicine, Tel Aviv University, Israel
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25
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Armitage NC. Familial Adenomatous Polyposis. Med Chir Trans 1992; 85:63-5. [PMID: 1311383 PMCID: PMC1294880 DOI: 10.1177/014107689208500201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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Abstract
Familial adenomatous polyposis (FAP) includes early development of up to thousands of colorectal adenomas and of colorectal adenocarcinoma in all untreated cases. Moreover, a variety of extracolonic manifestations are seen. Proctosigmoidoscopy is used for screening; when adenomas are found, the diagnostic evaluation includes colonoscopy and gastroduodenoscopy. Screening of first degree relatives should start at the age of 10 years, using proctosigmoidoscopy at regular intervals. The recent detection of a specific FAP gene at chromosome 5 and of congenital retinal pigmentations will allow an early preclinical diagnosis in the future. A centralized registration of FAP has resulted in an improved prognosis, and the establishment of international groups will contribute to increased research of this disease.
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Affiliation(s)
- S Bülow
- Danish Polyposis Registry, Department of Surgical Gastroenterology, Hvidovre University Hospital, Copenhagen
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27
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Affiliation(s)
- H J Järvinen
- Second Dept. of Surgery, Helsinki University Central Hospital, Finland
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28
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Kubo K, Miyatani H, Takenoshita Y, Abe K, Oka M, Iida M, Itoh H. Widespread radiopacity of jaw bones in familial adenomatosis coli. J Craniomaxillofac Surg 1989; 17:350-3. [PMID: 2592575 DOI: 10.1016/s1010-5182(89)80104-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Abnormalities of jaw bones and teeth were evaluated in 37 patients with familial adenomatosis coli (FAC) by means of orthopantomography. Osteomatous radiopaque lesions were evident in 75.7 percent of FAC patients (focal type: 62.2% and wide spread type: 13.5%), odontomes in 29.7% peripheral osteomas in 13.5%, unerupted teeth in 16.2% and supernumerary unerupted teeth in 16.2%. Five of the 37 FAC patients had an unusual widespread type of radiopacity with other abnormalities. Combined abnormalities were most frequent in patients with this type in comparison with patients with the focal type. Osteomas and peripheral osteomas were revealed in this type with statistical significance. Biopsy performed in one patient revealed an osteoma. These results suggest that the multiple abnormalities seen in oral X-ray examination may predict the occult existence of familial adenomatosis coli and these widespread radiopaque lesions probably represent the most extensive manifestation of FAC.
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Affiliation(s)
- K Kubo
- Second Dept. of Oral Surgery, Faculty of Dentistry, Kyushu University, Japan
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29
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Abstract
Familial adenomatous polyposis is an autosomal dominant disease that includes early development of up to thousands of colorectal adenomas and several extracolonic manifestations. All untreated patients will develop colorectal adenocarcinoma. The treatment of choice is colectomy and ileorectal anastomosis, but restorative proctocolectomy may be considered in selected cases. Polyposis patients treated with ileorectal anastomosis should be followed for life, with regular proctosigmoidoscopy and destruction of new adenomas. Furthermore, regular gastroduodenoscopy should be carried out because of frequent occurrence of premalignant duodenal adenomas. The prognosis is good after prophylactic colectomy in patients without carcinoma. All first degree relatives of affected family members should be examined regularly with proctosigmoidoscopy from the age of ten, and prophylaxis should be organised using a national or regional polyposis register. The recent detection of a specific gene for familial adenomatous polyposis is a long step forward, and several problems may be solved by increasing international cooperation.
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Affiliation(s)
- S Bülow
- Department of Surgical Gastroenterology, Hvidovre Hospital, University of Copenhagen, Denmark
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31
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Woods RJ, Sarre RG, Ctercteko GC, Jagelman DJ, Smith JW, Duchesneau PM, McGannon EA. Occult radiologic changes in the skull and jaw in familial adenomatous polyposis coli. Dis Colon Rectum 1989; 32:304-6. [PMID: 2538298 DOI: 10.1007/bf02553485] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
It has been suggested that radiology of the skull and jaw in familial polyposis coli may be a useful marker in up to 90 percent of cases. These x-rays were reviewed independently by a dental surgeon and a neuroradiologist in 51 patients. Only seven patients (14 percent) had significant lesion seen in the context of screening. Each of these patients also had other extracolonic manifestations of familial polyposis coli. The Cleveland Clinic Foundation experience with radiology of the jaw and skull is that it is not a useful screening tool.
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Affiliation(s)
- R J Woods
- Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio
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32
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Svendsen LB, Søndergaard JO, Bülow S, Lauritsen KB, Holm NV, Danes BS. Increased in vitro tetraploidy and mandibular osteomas in patients with and without colorectal diseases. Scand J Gastroenterol 1988; 23:529-33. [PMID: 3399825 DOI: 10.3109/00365528809093906] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
One hundred and seventy-six individuals with various colorectal diseases were investigated simultaneously for increased in vitro tetraploidy in dermal fibroblast cultures and for occult mandibular osteomas. In only 10 of the 176 persons were both presumed markers of colorectal genetic predisposition present in the same individual. No evidence was found that these traits are causally associated. A combination of the two presumed markers showed a tendency towards occurrence in individuals with a positive family history of colorectal cancer among first-degree relatives.
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Affiliation(s)
- L B Svendsen
- Dept. of Surgical Gastroenterology, Hvidovre Hospital, Denmark
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33
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Offerhaus GJ, Levin LS, Giardiello FM, Krush AJ, Welsh SB, Booker SV, Hasler JF, McKusick VA, Yardley JH, Hamilton SR. Occult radiopaque jaw lesions in familial adenomatous polyposis coli and hereditary nonpolyposis colorectal cancer. Gastroenterology 1987; 93:490-7. [PMID: 3038660 DOI: 10.1016/0016-5085(87)90910-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The purposes of this study were to determine the association, in 10 pedigrees, between adenomatous polyposis coli, hereditary nonpolyposis colorectal cancer, and occult radiopaque jaw lesions, and to assess whether these radiodensities are predictors for adenomatous polyposis. In seven kindreds with adenomatous polyposis, all patients with polyps had jaw lesions; in one kindred, no jaw lesions were found. In one of two kindreds with hereditary nonpolyposis colorectal cancer, no affected individuals had jaw lesions. In the other, the 1 affected patient with dental radiographs had generalized jaw lesions. Twelve children less than 16 yr old at risk for adenomatous polyposis were observed. Seven children with jaw lesions developed polyps after a mean interval of 4 yr. Five children without jaw lesions were polyp-free during a 5-10-yr follow-up. Thus, occult jaw lesions are consistently found only in some families with adenomatous polyposis coli, providing support for heterogeneity in polyposis syndromes. Jaw lesions are good predictors for polyp development in kindreds with adenomatous polyposis coli and jaw lesions. Their role as markers in hereditary nonpolyposis colorectal cancer needs exploration.
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34
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Lynch HT, Priluck I, Fitzsimmons ML. Congenital hypertrophy of retinal pigment epithelium in non-Gardner's polyposis kindreds. Lancet 1987; 2:333. [PMID: 2886789 DOI: 10.1016/s0140-6736(87)90918-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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35
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Svendsen LB, Søndergaard JO, Hegnhøj J, Højgård L, Lauritsen KB, Bülow S, Horn T, Danes BS. In vitro tetraploidy in patients with ulcerative colitis. Scand J Gastroenterol 1987; 22:601-5. [PMID: 3629185 DOI: 10.3109/00365528708991905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
One hundred and seven patients (57 patients with ulcerative colitis and 50 controls) were investigated for in vitro tetraploidy (IVT) in dermal fibroblast monolayer cultures. There was no difference in incidence of IVT between patients with ulcerative colitis and controls. We advance the hypothesis that the genetic background of the colorectal cancer type found in ulcerative colitis differs from that found in the colon cancer syndromes and in non-hereditary colorectal cancers. Colorectal cancer in ulcerative colitis is probably only dependent on the degree of inflammatory lesions of the colonic mucosa.
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36
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Søndergaard JO, Bülow S, Järvinen H, Wolf J, Witt IN, Tetens G. Dental anomalies in familial adenomatous polyposis coli. Acta Odontol Scand 1987; 45:61-3. [PMID: 3031923 DOI: 10.3109/00016358709094355] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Forty-seven Danish and 50 Finnish patients with familial adenomatous polyposis coli (FPC) were studied by panoramic tomography (PTG) of the mandible, which showed dental abnormalities in 17% of the cases. Eleven patients (11%) had supernumerary teeth and/or compound osteomas, and nine patients (9%) had impacted permanent teeth. The frequency of the dental anomalies was statistically significantly higher in FPC patients than in the normal population; it is therefore concluded that this dental abnormality should be included in the list of extracolonic manifestations that may occur in any FPC patient. The frequency of dental anomalies was higher in Finnish than in Danish patients, probably owing to a higher frequency of extracolonic manifestations in the Finnish series.
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37
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Svendsen LB, Bülow S, Søndergaard JO, Lauritsen KB, Danes BS. In vitro tetraploidy in patients with non-hereditary colorectal adenoma and carcinoma. Support for a genetic influence on the pathogenesis of colorectal carcinoma. Scand J Gastroenterol 1987; 22:106-10. [PMID: 3563403 DOI: 10.3109/00365528708991865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
One hundred and seventy-two patients (76 patients with colorectal cancer, 46 with adenoma of the colon or rectum, and 50 controls) were investigated for in vitro tetraploidy in dermal fibroblast monolayer cultures. The incidence of increased in vitro tetraploidy (IVT) among patients with adenoma or carcinoma was significantly different from that of controls. There was no difference in the incidence of IVT between the adenoma patients and those with colorectal cancer. IVT was investigated among different subgroups of adenoma and colorectal cancer patients and was only found to be related to an inherited tendency to colorectal cancer.
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38
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Bülow S. Incidence of associated diseases in familial polyposis coli. SEMINARS IN SURGICAL ONCOLOGY 1987; 3:84-7. [PMID: 3035693 DOI: 10.1002/ssu.2980030207] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In this review we present diseases associated with hereditary polyposis syndromes. In addition to the known extracolonic manifestations of the so-called Gardner's syndrome, other important diseases are carcinomas of the thyroid and of the small bowel and bile duct adenoma. The incidence of these diseases is discussed.
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39
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Wolf J, Järvinen HJ, Hietanen J. Gardner's dento-maxillary stigmas in patients with familial adenomatosis coli. Br J Oral Maxillofac Surg 1986; 24:410-6. [PMID: 3024698 DOI: 10.1016/0266-4356(86)90054-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Fifty patients with familial adenomatosis coli (FAC) studied by panoramic tomography (PTG) showed osteomatous jaw changes in 82% as compared with 10% in matched controls. Supernumerary teeth, compound odontomas and/or impacted teeth were seen in 30% of the patients compared with 4% of the controls. A correlation was found between dental abnormalities and the large number of osteomas. The results support the view that both osteomas of the jaws and dental abnormalities are features of FAC. PTG of the jaws may serve as a valuable tool for early detection of FAC by oral surgeons, at least in the case of the most striking changes (about 20%).
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40
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Abstract
Orthopantomography of the mandible in 50 consecutive patients with ulcerative colitis showed mandibular osteomas in 2 patients (4%), which is the same frequency as found in the normal population. Since earlier investigations have shown an increased frequency of mandibular osteomas in familial polyposis coli, the cancer family syndrome, and colorectal cancer without known familial disposition, it is concluded that the etiology of colorectal carcinoma in ulcerative colitis is not, as for these diseases, a combination of the same genetic and environmental factors but probably only a function of the duration and involvement of the disease.
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41
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Bülow S, Holm NV, Søndergaard JO, Witt IN, Tetens G. Mandibular osteomas in unaffected sibs and children of patients with familial polyposis coli. Scand J Gastroenterol 1986; 21:744-8. [PMID: 3749807 DOI: 10.3109/00365528609011111] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Orthopantomography of the mandible (OTM) showed osteomas in 3 of 34 non-affected sibs and children of the probands in 14 families with polyposis coli. The observed to expected ratio with osteomas was 0.35, which is not significantly lower than 1.0 and in accordance with the frequency in the normal population. Although the result does not enable a definite evaluation of the diagnostic value of OTM, the finding suggests that this method may be used as a supplement to regular proctosigmoidoscopic screening of first-degree relatives of polyposis patients.
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42
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Søndergaard JO, Svendsen LB, Witt IN, Bülow S, Lauritsen KB, Tetens G. Mandibular osteomas in colorectal adenomas. Scand J Gastroenterol 1986; 21:723-4. [PMID: 3749805 DOI: 10.3109/00365528609011107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Orthopantomography of the mandible was carried out on 50 patients with colorectal adenoma(s) without carcinoma or any known familial disposition. Four patients (8%) had osteomas, and we advance the hypothesis that individuals with both osteomas and adenomas represent a separate type of adenoma patient. Further studies are needed to evaluate the prognostic value of the association of adenomas and mandibular osteomas.
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43
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Abstract
Three hundred nineteen affected members of 94 Danish families with familial polyposis coli had been registered in the Danish Polyposis Register by the end of 1982. Of the 247 histologically verified cases, 168 were propositi and 79 were call-up patients. The frequency of colorectal cancer at the time of diagnosis of polyposis was 69 percent in propositi vs. 3 percent in call-up patients. The cumulative survival rate after ten years was 97 percent in call-up patients, as compared to 42 percent in propositi. The prognosis of polyposis patients has improved significantly since the establishment of the Danish Polyposis Register in 1971.
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44
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Søndergaard JO, Svendsen LB, Witt IN, Bülow S, Lauritsen KB, Tetens G. Mandibular osteomas in the cancer family syndrome. Br J Cancer 1985; 52:941-3. [PMID: 4074647 PMCID: PMC1977264 DOI: 10.1038/bjc.1985.281] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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45
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Søndergaard JO, Svendsen LB, Witt IN, Bülow S, Lauritsen KB, Tetens G. Mandibular osteomas in colorectal cancer. Scand J Gastroenterol 1985; 20:759-61. [PMID: 4035295 DOI: 10.3109/00365528509089209] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Orthopantomography of the mandible was carried out on 50 patients with colorectal cancer without known familial disposition. Twelve patients (24%) had osteomas, as against 5% in the control group (P less than 0.001). Since an increased occurrence of mandibular osteomas has earlier been demonstrated in cases of familial polyposis coli and the family cancer syndrome, we must conclude that genetic factors are presumably of more importance in the development of colorectal cancer than previously assumed.
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46
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Lynch HT, Fitzgibbons R, Marcus J, McGill J, Voorhees GJ, Lynch JF. Colorectal cancer in a nuclear family. Familial or hereditary? Dis Colon Rectum 1985; 28:310-6. [PMID: 3996146 DOI: 10.1007/bf02560430] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Because of the high incidence of colorectal cancer, familial aggregations of this disease are common. Differentiation between etiologies contributing to familial clustering (which may have resulted either from common environmental exposure or from mere chance) and primary genetic factors may prove vexing to the physician. This report deals with the myriad problems encountered when attempting to make such etiologic distinctions in order to provide appropriate surveillance and management, based upon tumor spectrum and natural history, for patients at increased cancer risk.
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