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Dang Y, Xu Q, Liu X, Wang L, Lin C. Clinical and functional characterisation of the SMAD4 germline variant c.1035C > A in a family with juvenile polyposis syndrome by whole-exome sequencing. Med Mol Morphol 2023; 56:78-83. [PMID: 35851413 DOI: 10.1007/s00795-022-00333-w] [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: 05/15/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022]
Abstract
Juvenile polyposis syndrome (JPS) is a rare autosomal dominant inherited disease characterised by multiple juvenile polyps. Genes with JPS-associated mutations and their correlation with the phenotype are currently unknown. Gastrointestinal endoscopy results of a 31-year-old female patient showed multiple polyps in the digestive tract, and the presence of juvenile polyps was confirmed by pathological examination. During follow-up, the patient underwent total gastrectomy and polypectomy several times. Five members of this family were diagnosed with JPS, of which two died and three survived. Full exon gene sequencing of eight members of this family revealed a SMAD4 (NM-005359.3) c.1035C > A (p.Cys345*) mutation. This mutation leads to premature codon termination, causing protein truncation. SMAD4 is a pathogenic gene associated with JPS. This is the first report of an association between the c.1035C > A mutation and JPS pathogenesis. Detection of JPS-related mutations in family members with a genetic predisposition for JPS is very important for genetic counselling, surgical intervention, long-term monitoring and follow-up, and drug treatment.
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Affiliation(s)
- Yuan Dang
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, 350025, Fujian, China.,Innovation Center for Cancer Research, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, Fujian, China.,Fujian Key Laboratory of Advanced Technology for Cancer Screening and Early Diagnosis, Fujian Cancer Hospital, Fuzhou, China
| | - Qianhui Xu
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, 350025, Fujian, China.,Department of General Surgery, 900th hospital of Joint Logistics Support Force, 156 Xierhuan Road, Fuzhou, 350025, Fujian, China.,Department of General Surgery, Dongfang Hospital of Xiamen university, School of Medicine, Xiamen University, 156 Xierhuan Road, Fuzhou, 350025, Fujian, China
| | - Xiaofang Liu
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, 350025, Fujian, China.,Department of General Surgery, 900th hospital of Joint Logistics Support Force, 156 Xierhuan Road, Fuzhou, 350025, Fujian, China.,Department of General Surgery, Dongfang Hospital of Xiamen university, School of Medicine, Xiamen University, 156 Xierhuan Road, Fuzhou, 350025, Fujian, China
| | - Lie Wang
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, 350025, Fujian, China. .,Department of General Surgery, 900th hospital of Joint Logistics Support Force, 156 Xierhuan Road, Fuzhou, 350025, Fujian, China. .,Department of General Surgery, Dongfang Hospital of Xiamen university, School of Medicine, Xiamen University, 156 Xierhuan Road, Fuzhou, 350025, Fujian, China.
| | - Chen Lin
- Department of General Surgery, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, 350025, Fujian, China. .,Department of General Surgery, 900th hospital of Joint Logistics Support Force, 156 Xierhuan Road, Fuzhou, 350025, Fujian, China. .,Department of General Surgery, Dongfang Hospital of Xiamen university, School of Medicine, Xiamen University, 156 Xierhuan Road, Fuzhou, 350025, Fujian, China.
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Gorji L, Albrecht P. Hamartomatous polyps: Diagnosis, surveillance, and management. World J Gastroenterol 2023; 29:1304-1314. [PMID: 36925460 PMCID: PMC10011967 DOI: 10.3748/wjg.v29.i8.1304] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/08/2022] [Accepted: 02/16/2023] [Indexed: 02/28/2023] Open
Abstract
Hereditary polyposis syndrome can be divided into three categories: Ade-nomatous, serrated, and hamartomatous polyps. Hamartomatous polyps, malformations of normal tissue presenting in a disorganized manner, are characterized by an autosomal dominant inheritance pattern. These syndromes exhibit hamartomatous gastrointestinal polyps in conjunction to extra-intestinal manifestations, which require conscientious and diligent monitoring. Peutz-Jeghers syndrome, Cowden syndrome, and juvenile polyposis syndrome are the most common displays of hamartomatous polyposis syndrome (HPS). Diagnosis can be pursued with molecular testing and endoscopic sampling. Early identification of these autosomal dominant pathologies allows to optimize malignancy sur-veillance, which helps reduce morbidity and mortality in both the affected patient population as well as at-risk family members. Endoscopic surveillance is an important pillar of prognosis and monitoring, with many patients eventually requiring surgical intervention. In this review, we discuss the diagnosis, surveillance, and management of HPS.
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Affiliation(s)
- Leva Gorji
- Department of Surgery, Kettering Health Dayton, Dayton, OH 45405, United States
| | - Peter Albrecht
- Department of Surgery, Kettering Health Dayton, Dayton, OH 45405, United States
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Liu Y, Wang Z, Zhang Z, Sun Y, Zhang Y, Yang J. A case report of adult juvenile polyposis syndrome with SMAD4 pathogenic variant. Front Oncol 2023; 13:1114097. [PMID: 36950548 PMCID: PMC10025567 DOI: 10.3389/fonc.2023.1114097] [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: 12/02/2022] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
Background Juvenile polyposis syndrome (JPS) is a rare autosomal dominant disorder that is a type of hamartomatous polyp syndrome, and its incidence rate is approximately 1/100000. The main clinical feature is the presence of multiple juvenile polyps in the gastrointestinal tract, most often in the colorectal tract. We present a case of juvenile polyposis syndrome with massive gastric polyposis. Case presentation A 50-year-old male was admitted to the hospital due to abdominal distension and poor appetite. Gastroscopy revealed a large number of gastric polyps. Pathological findings revealed gastric juvenile polyps. Genetic testing revealed that he and his brother both carried SMAD4: c.266_269del germline pathogenic variant. The final diagnosis was juvenile polyposis syndrome of the stomach. He once suffered from colon cancer and bladder cancer. One of his brothers died of colon cancer, and the other brother suffered from colon polyps. Conclusions Gastric involvement in juvenile polyposis syndrome is relatively rare. When massive gastric polyposis is found, gene detection should be carried out as soon as possible, so that rapid diagnosis and treatment can be obtained.
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