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Chen C, Zhang X, Wang D, Wang F, Pan J, Wang Z, Liu C, Wu L, Lu H, Li N, Wei J, Shi H, Wan H, Zhu M, Chen S, Zhou Y, Zhou X, Yang L, Liu J. Genetic Screening and Analysis of LKB1 Gene in Chinese Patients with Peutz-Jeghers Syndrome. Med Sci Monit 2016; 22:3628-3640. [PMID: 27721366 PMCID: PMC5070620 DOI: 10.12659/msm.897498] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Peutz-Jeghers syndrome (PJS) is an autosomal dominant genetic disease. It severely decreases patient quality of life and leads elevated cancer risk. Germline mutation of LKB1 is the leading cause of familial PJS. MATERIAL AND METHODS To characterize the germline mutation of LKB1 gene in Chinese familial and sporadic PJS patients, 14 PJS families, 5 sporadic PJS patients, and 250 healthy adults were collected and genomic DNAs of peripheral blood were extracted. Mutation screenings of LKB1 were performed using MLPA (multiplex ligation-dependent probe amplification), PCR, direct sequencing, and PCR-DHPLC (denaturing high-performance liquid chromatography). RESULTS A total of 12 kinds of germline mutations were found in 9 familial PJS patients, most of which were point mutations (7/12); 4 large deletions of LKB1 were also observed. Of the 12 mutations, 7 were pathogenic (2 were de novo), 4 were just polymorphisms, and 1 was indefinitely pathogenic. No pathogenic mutation in exons of the LKB1 gene was detected in the 5 sporadic PJS patients. The mutation detection rate for the LKB1 gene was 85.7% in our Chinese familial PJS and 63.2% in all Chinese PJS patients. Eight familial PJS patients were identified with pathogenic germline mutations in 14 unrelated families (57.1%). Further methylation detection and analysis showed promoter methylation in carcinomatous polyps. CONCLUSIONS LKB1 gene germline mutation with pathogenic effect is a common cause of familial PJS in Chinese patients; however, it is not the only molecular pathogen of PJS. Methylation in the LKB1 gene promoter region may cause carcinomatous change in intestinal polyps.
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Affiliation(s)
- Chunyan Chen
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Xiaomei Zhang
- Laboratory of Genetics and Molecular Biology, Jiangsu Province Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China (mainland)
| | - Deqiang Wang
- The Cancer Therapy Center, Affiliated Hospital of Jiangsu University, Nanjing, Jiangsu, China (mainland)
| | - Fangyu Wang
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Jian Pan
- Department of Gastroenterology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Zhenkai Wang
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Chang Liu
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Lin Wu
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Heng Lu
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Nan Li
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Juan Wei
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Hui Shi
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Haijun Wan
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
| | - Ming Zhu
- Laboratory of Genetics and Molecular Biology, Jiangsu Province Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China (mainland)
| | - Senqing Chen
- Laboratory of Genetics and Molecular Biology, Jiangsu Province Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, Jiangsu, China (mainland)
| | - Yun Zhou
- Department of Medicine, Jiangsu Cancer Hospital, Nanjing, Jiangsu, China (mainland)
| | - Xin Zhou
- Department of General Surgery, Jiangsu Cancer Hospital, Nanjing, Jiangsu, China (mainland)
| | - Liu Yang
- Department of General Surgery, Jiangsu Cancer Hospital, Nanjing, Jiangsu, China (mainland)
| | - Jiong Liu
- Department of Gastroenterology and Hepatology, Jinling Hospital, Nanjing, Jiangsu, China (mainland)
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Noriega-Iriondo MF, Colon-Otero G, Kipp BR, Copland JA, Ferber MJ, Marlow LA, Roberts ME, Robertson MW, Dinh TA, Attia S, Geiger XJ, Riegert-Johnson DL. High-grade endometrial stromal sarcoma as the initial presentation of an adult patient with Peutz-Jeghers Syndrome: a case report. Hered Cancer Clin Pract 2015; 13:6. [PMID: 25649062 PMCID: PMC4314827 DOI: 10.1186/s13053-015-0027-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 01/15/2015] [Indexed: 12/18/2022] Open
Abstract
A 46-year-old female presents with a pelvic mass and is diagnosed as having a high-grade endometrial stromal sarcoma. During surgery, she is noted to have areas of intussusception of the small bowel secondary to large hamartomatous polyps. The patient had a previous history of small bowel obstruction secondary to what had been thought to be hyperplastic polyps but represented hamartomatous polyps on further review. Additional examination revealed the presence of subtle hyperpigmented macules on the fingers leading to a diagnosis of Peutz-Jeghers Syndrome (PJS). The diagnosis was confirmed by the presence of a germ-line STK11 mutation. Immunohistochemistry analysis of the tumor showed decreased expression of STK-11 as compared to one of the patient's hamartomatous polyps. Next generation sequencing of the tumor specimen failed to demonstrate a "second hit" somatic mutation in STK-11. This case represents the first case of endometrial stromal sarcoma associated with PJS and illustrates the importance of increased awareness of this condition among oncologists. PJS is associated with dysregulation of the mTOR pathway; treatment with an mTOR inhibitor was not effective in this case.
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Affiliation(s)
| | - Gerardo Colon-Otero
- Division of Hematology/Oncology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Benjamin R Kipp
- Department of Laboratory Medicine, Mayo Clinic, 55902 Rochester, MN USA
| | - John A Copland
- Department of Cancer Cell Biology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Matthew J Ferber
- Department of Laboratory Medicine, Mayo Clinic, 55902 Rochester, MN USA
| | - Laura A Marlow
- Department of Cancer Cell Biology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Maegan E Roberts
- Division of Hematology/Oncology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Matthew W Robertson
- Department of Surgical Gynecology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Tri A Dinh
- Department of Surgical Gynecology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Steven Attia
- Division of Hematology/Oncology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Xochiquetzal J Geiger
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
| | - Douglas L Riegert-Johnson
- Department of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224 USA
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Udd L, Gao Y, Ristimäki AP, Mäkelä TP. N-methylnitrosourea aggravates gastrointestinal polyposis in Lkb1+/- mice. Carcinogenesis 2013; 34:2409-14. [PMID: 23722652 DOI: 10.1093/carcin/bgt188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Peutz-Jeghers patients develop hamartomatous polyps and carcinomas of the gastrointestinal tract. Cyclooxygenase-2 accelerates polyp growth in Lkb1 (+/-) mice modelling Peutz-Jeghers polyposis. In this study, we aimed to evaluate the effect of the mutagenic carcinogen N-methylnitrosourea (MNU) on gastrointestinal tumourigenesis in Lkb1 (+/-) mice and to investigate the role of cyclooxygenase-2 on the tumourigenesis. We treated 40 Lkb1 (+/-) and 51 wild-type mice with MNU, 10 mice from both groups received the cyclooxygenase-2 inhibitor celecoxib. Carcinogen-treated Lkb1 (+/-) mice displayed worse survival (60%) than treated wild-type (100%, P = 0.028) or untreated Lkb1 (+/-) mice (92%, P = 0.045). Also, the gastrointestinal tumour burden was almost 10-fold higher in carcinogen-treated (2181 mm(3)) than in untreated (237 mm(3), P = 0.00045) Lkb1 (+/-) mice. Celecoxib was much less efficient in reducing tumourigenesis in MNU-treated mice (by 23%; 1686 mm(3)) than in untreated mice (76%; 58 mm(3)). Surprisingly, the increase in tumour burden in MNU-treated mice was not accompanied by consistent histological changes, with only a single focus of epithelial dysplasia noted. This study suggests that MNU promotes Peutz-Jeghers polyposis independently from the acceleration by cyclooxygenase-2.
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Affiliation(s)
- Lina Udd
- Institute of Biotechnology, University of Helsinki, Helsinki 00014, Finland and
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Abstract
Cutaneous markers of systemic disease are vital for clinicians to recognize. This chapter outlines familial lentiginosis syndromes that include Peutz-Jeghers syndrome, Carney Complex, the PTEN hamartomatous syndromes, and LEOPARD/Noonan syndrome. The inheritance of these syndromes is autosomal dominant; they also share characteristic skin findings that offer a clue to their recognition and treatment. We will discuss the clinical presentation of these disorders, with a focus on the dermatological manifestations, and will provide an update on the molecular mechanisms involved. Recognition of cutaneous markers associated with these rare familial cancer syndromes provides the opportunity to pursue early surveillance for malignancies, as well as genetic counseling.
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Affiliation(s)
- Maya B Lodish
- Section on Endocrinology and Genetics, Program on Developmental Endocrinology Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Pediatric Endocrinology Inter-Institute Training Program, National Institutes of Health, Building 10, CRC Room 1-3330, 10 Center Drive, MSC 1103, Bethesda, MD, 20892, USA.
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Kim MP, Evans DB, Vu TM, Fleming JB. The recognition and surgical management of heritable lesions of the pancreas. Surg Oncol Clin N Am 2009; 18:99-119, ix. [PMID: 19056044 DOI: 10.1016/j.soc.2008.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Our knowledge regarding the inherited factors that lead to the development of lesions within the pancreas is clearly incomplete. This article addresses clinical issues in patients at moderate-to-high risk for pancreatic malignancy, with special emphasis on the recognition and diagnosis of known genetic syndromes. Using the current available information, the authors attempt to equip the practicing surgeon with critical information to increase clinical suspicion for heritable syndromes and inform specific surgical management. Additionally, this article is meant to encourage the practicing surgeon to participate in the genetic testing/screening, cancer surveillance, and prevention activities of patients who have heritable cancer syndromes and associated pancreatic lesions that require surgery.
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Affiliation(s)
- Michael P Kim
- Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
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Abstract
Cowden disease is a genetically inherited disorder presenting with multiple hamartomatous and neoplastic lesions in various organs and tissues. We present a review of the diagnostic criteria, clinical presentation, genetics, and management of this condition.
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Affiliation(s)
- S Uppal
- Molecular Medicine Unit, University of Leeds, St. James's University Hospital, Leeds, UK.
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Abstract
This review focuses on remarkable recent findings concerning the mechanism by which the LKB1 protein kinase that is mutated in Peutz-Jeghers cancer syndrome operates as a tumor suppressor. We discuss evidence that the cellular localization and activity of LKB1 is controlled through its interaction with a catalytically inactive protein resembling a protein kinase, termed STRAD, and an armadillo repeat-containing protein, named mouse protein 25 (MO25). The data suggest that LKB1 functions as a tumor suppressor by not only inhibiting proliferation, but also by exerting profound effects on cell polarity and, most unexpectedly, on the ability of a cell to detect and respond to low cellular energy levels. Genetic and biochemical findings indicate that LKB1 exerts its effects by phosphorylating and activating 14 protein kinases, all related to the AMP-activated protein kinase. The work described in this review shows how a study of an obscure cancer syndrome can uncover new and important regulatory pathways, relevant to the understanding of multiple human diseases.
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Affiliation(s)
- Dario R Alessi
- Medical Research Council, Protein Phosphorylation Unit, School of Life Sciences, University of Dundee, Dundee DD1 5EH, Scotland.
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Latchford A, Greenhalf W, Vitone LJ, Neoptolemos JP, Lancaster GA, Phillips RKS. Peutz-Jeghers syndrome and screening for pancreatic cancer. Br J Surg 2007; 93:1446-55. [PMID: 17115408 DOI: 10.1002/bjs.5609] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cancer risk, including pancreatic, is high in those with Peutz-Jeghers syndrome (PJS). It has been suggested that such patients should undergo screening for pancreatic cancer. METHODS The risk of pancreatic cancer in PJS, pancreatic screening and potential screening strategies were reviewed. Cost-effectiveness was assessed according to American Gastroenterology Association guidelines and a risk stratification model proposed by the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer. RESULTS The risk of pancreatic cancer is increased in PJS but screening would cost over US 35,000 dollars per life saved. Risk stratification reduces cost by 100,000 dollars and costs fall to 50,000 dollars per life saved if deaths from other forms of cancer are avoided. CONCLUSION Screening should be performed only on a research basis to evaluate the benefit and cost-effectiveness in high-risk groups.
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Affiliation(s)
- A Latchford
- Polyposis Registry, St Mark's Hospital, Northwick Park, Harrow, UK
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Affiliation(s)
- Anders Merg
- Roswell Park Cancer Institute, Buffalo, New York, USA
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N/A. N/A. Shijie Huaren Xiaohua Zazhi 2003; 11:1773-1776. [DOI: 10.11569/wcjd.v11.i11.1773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Abstract
LKB1 is a serine-threonine protein kinase mutated in patients with an autosomal dominantly inherited cancer syndrome predisposing to multiple benign and malignant tumours, termed Peutz-Jeghers syndrome. Since its discovery in 1998, much research has focused on identification and characterisation of its cellular roles and analysing how LKB1 might be regulated. In this review we discuss exciting recent advances indicating that LKB1 functions as a tumour suppressor perhaps by controlling cell polarity. We also outline the current understanding of the molecular mechanisms by which LKB1 is regulated in vivo, through interaction with other proteins as well as by protein phosphorylation and prenylation.
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Affiliation(s)
- Jérôme Boudeau
- MRC Protein Phosphorylation Unit, MSI/WTB Complex, University of Dundee, Dow Street, Dundee DD1 5EH, UK
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Abstract
Many genodermatoses have distinct oral features that may help identify or confirm a genetic diagnosis. Oral features of the disorders described here are summarized in Table 1. These conditions provide clear examples of rapid progress in the field of genetic technology relevant to patient care. Less than a decade ago, the exact genetic locus of most of these disorders was unknown. Today, for many of these disorders, the exact location of the disease-causing mutation is known and clinical genetic testing is available for patients. This information has impact not only for genetic counseling and anticipatory medical care, but also provides insight into the mechanisms of disease. How this rapid progress will impact care, and ultimately treatment of patients, remains to be seen.
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Affiliation(s)
- Jennifer L Hand
- Department of Dermatology, Mayo Clinic, 200 First Street SW Rochester, MN 55905, USA.
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Scott RJ, Crooks R, Meldrum CJ, Thomas L, Smith CJA, Mowat D, McPhillips M, Spigelman AD. Mutation analysis of the STK11/LKB1 gene and clinical characteristics of an Australian series of Peutz-Jeghers syndrome patients. Clin Genet 2002; 62:282-7. [PMID: 12372054 DOI: 10.1034/j.1399-0004.2002.620405.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Peutz-Jeghers syndrome (PJS) is a rare cancer predisposition, which is characterized by the presence of hamartomatous polyposis and mucocutaneous pigmentation. A significant proportion of both familial and sporadic forms of this disorder are associated with mutations in the STK11 (serine/threonine kinase 11)/LKB1 gene. In this report we present a series of Australian PJS cases, which suggest that mutations in the STK11 gene do not account for many families or patients without a family history. The most likely explanation is either the presence of another susceptibility gene or genetic mosaicism in the non-familial patients.
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Affiliation(s)
- R J Scott
- Discipline of Medical Genetics, Faculty of Health, University of Newcastle, NSW, Australia.
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Braud AC, de Rocquancourt A, Marty M, Espie M. Cowden disease and Lhermitte Duclos disease, markers of breast carcinoma: report of two patients. Ann Oncol 1999; 10:1241-3. [PMID: 10586343 DOI: 10.1023/a:1008317923860] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A C Braud
- Service d'Oncologie Medicale, Hopital Saint Louis, Paris, France
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Ward SK, Roenigk HH, Gordon KB. Dermatologic manifestations of gastrointestinal disorders. Gastroenterol Clin North Am 1998; 27:615-36, vi. [PMID: 9891700 DOI: 10.1016/s0889-8553(05)70023-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Many disorders of the gastrointestinal tract have cutaneous manifestations. Thus, a careful examination of the skin may uncover clues to underlying diseases of the liver, gastrointestinal tract, and pancreas. This article explores the alimentary-cutaneous relationship.
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Affiliation(s)
- S K Ward
- Department of Dermatology, Northwestern University Medical School, Chicago, Illinois, USA
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Abstract
Specific cutaneous manifestations are found to be associated with gastrointestinal disease. A careful examination of the skin, therefore, may uncover clues to underlying diseases of the gastrointestinal tract, pancreas, and liver. This article explores the alimentary cutaneous relationship.
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Affiliation(s)
- S K Katz
- Department of Dermatology, Northwestern University Medical School, Chicago, Illinois, USA
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Poole S, Fenske NA. Cutaneous markers of internal malignancy. I. Malignant involvement of the skin and the genodermatoses. J Am Acad Dermatol 1993; 28:1-13. [PMID: 8425947 DOI: 10.1016/0190-9622(93)70001-a] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Cutaneous findings often reflect the presence and course of an internal disease. Recognition of external clues is important to facilitate both early diagnosis and prompt treatment of the internal disorder. Early recognition is especially valuable in a patient with an internal malignant disease because intervention may significantly affect survival. In this two-part series, we review the spectrum of cutaneous markers of internal malignancy. Part I focuses on malignant involvement of the skin caused by either direct extension or metastases and the genodermatoses with malignant potential. Part II will be devoted to the paraneoplastic skin manifestations of internal malignancy as well as environmental carcinogens that produce cutaneous features. We also discuss some proposed but controversial associations between skin disease and internal malignancy.
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Affiliation(s)
- S Poole
- Division of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa 33612
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Abstract
BACKGROUND Cowden syndrome (CS) is a rare but underdiagnosed autosomal dominant condition also known as "multiple hamartoma-neoplasia syndrome." Patients have multiple tricholemmomas (a type of benign skin appendage tumor) and oral papillomatosis and cutaneous keratoses. They often have goiter, gastrointestinal polyps, and hamartomatous soft tissue lesions. Breast cancer affects approximately one third of women with CS. Lhermitte-Duclos disease (LDD) is a peculiar proliferation of abnormal neuronal elements of the cerebellum that has features of a hamartoma and of a neoplasm. METHODS The authors described two patients who have both CS and LDD. Also reviewed were 50 of approximately 62 previously described cases of LDD (identified through literature searches) in an effort to find patients with LDD who had other associated lesions. RESULTS Only one other patient in whom both LDD and CS were recognized has been reported. In addition, a number of patients with LDD who had other neoplasms and/or thyroid lesions have been described. CONCLUSIONS Given the rarity of these two entities, we believe that their association is not fortuitous. LDD fits into the concept of CS as a hamartoma-neoplasia syndrome. In addition, a number of patients with LDD who had other neoplasms or thyroid lesions have been reported, raising the possibility that CS and LDD are more closely linked than is generally appreciated. We suspect that there are more patients with LDD who have unrecognized CS. Patients with either of the two diseases should be examined and followed up for evidence of the other.
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Affiliation(s)
- S Albrecht
- Department of Pathology, Methodist Hospital, Baylor College of Medicine, Houston, Texas 77030
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Abstract
This article reviews the cutaneous manifestations of gastrointestinal tract diseases. In part I, the gastrointestinal tract polyposis syndromes and gastrointestinal tract malignancies will be discussed. The cutaneous manifestations of inflammatory bowel disorders, vascular disorders of the gastrointestinal tract, celiac disease and bowel-associated dermatosis-arthritis syndrome will be discussed in part II. For each entity, a brief summary of the gastrointestinal tract (and other extracutaneous) manifestations is given. This is followed by a detailed discussion of the cutaneous signs. Current guidelines for the investigation and management of these diseases are presented.
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Affiliation(s)
- B Gregory
- Division of Dermatology, University of British Columbia, Vancouver, Canada
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Benedict LM, Cohen B. Treatment of Peutz-Jeghers lentigines with the carbon dioxide laser. THE JOURNAL OF DERMATOLOGIC SURGERY AND ONCOLOGY 1991; 17:954-5. [PMID: 1960267 DOI: 10.1111/j.1524-4725.1991.tb01697.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Perioral dark brown macules quickly identify patients with Peutz-Jeghers syndrome. These lentigines may be cosmetically disfiguring. We report a successful outcome in the treatment of these lentigines with the carbon dioxide laser.
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Affiliation(s)
- L M Benedict
- Department of Dermatology, University of Pittsburgh, Pennsylvania
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