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Olaopa OI, Dada AA, Soneye OY, Iyapo O, Akinniyi TA, Adisa AO, Kanmodi KK, Olaopa AO, Emeka CI, Ehanire ID, Coker MO. A rare case of Gardner syndrome in an African adult male: A case report. Clin Case Rep 2024; 12:e8735. [PMID: 38576527 PMCID: PMC10991715 DOI: 10.1002/ccr3.8735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/08/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024] Open
Abstract
Gardner's syndrome with the complete manifestation of colonic and extracolonic features is uncommon. Therefore, every clinician should view extracolonic features with a high index of suspicion. This may be key to early diagnosis, definitive management in these patients and importantly, helps prevent malignant transformation of existing colonic polyps.
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Affiliation(s)
- Olusegun I. Olaopa
- Department of Dental ServicesFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Adedamola A. Dada
- Department of SurgeryFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | | | - Oluwadamilare Iyapo
- Department of Pathologic ServicesFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Taofeek A. Akinniyi
- Department of Oral and Maxillofacial SurgeryObafemi Awolowo University Teaching Hospitals ComplexIle‐IfeOsun StateNigeria
| | - Akinyele O. Adisa
- Department of Oral PathologyCollege of Medicine, University of IbadanIbadanOyo StateNigeria
| | - Kehinde K. Kanmodi
- School of DentistryUniversity of RwandaKigaliRwanda
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
| | | | - Christian I. Emeka
- Department of Dental ServicesFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Imudia D. Ehanire
- Department of SurgeryFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Modupe O. Coker
- Department of Oral BiologyRutgers School of Dental MedicineNewarkNew JerseyUSA
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Soni S, Bhargava A. Revisiting peripheral osteoma of the mandible with case series and review of literature. Indian J Otolaryngol Head Neck Surg 2014; 66:212-8. [PMID: 24822166 PMCID: PMC4016348 DOI: 10.1007/s12070-012-0583-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 10/17/2012] [Indexed: 10/27/2022] Open
Abstract
Osteomas are benign lesions composed of mature compact and cancellous bone usually arising from craniofacial region. They can be central or peripheral, solitary or multiple. We are presenting few cases of giant peripheral osteoma's of the mandible along with review literature of other jaw lesions with their diagnostic features and differential diagnosis. The purpose of presenting this paper is to evaluate radiopaque lesions of the jaw which require proper clinical and histological evaluation to reach a final diagnosis.
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Affiliation(s)
- S. Soni
- />Department of ENT, Gandhi Medical College, F-1 Doctor’s Quarter Idgah Hills, Bhopal, 462001 India
| | - A. Bhargava
- />Department of Dental Surgery, Gandhi Medical College, Bhopal, 462001 India
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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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Kerckhaert A, Wolvius E, van der Wal K, Oosterhuis JW. A giant osteoma of the mandible: case report. J Craniomaxillofac Surg 2005; 33:282-5. [PMID: 15978820 DOI: 10.1016/j.jcms.2005.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2005] [Accepted: 03/01/2005] [Indexed: 10/25/2022] Open
Abstract
A 53-year-old patient with a giant osteoma of the right mandible is presented. The clinicopathological features of osteoma of the mandible are discussed and Gardner's syndrome was excluded.
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Affiliation(s)
- Arjen Kerckhaert
- Department of Oral and Maxillofacial Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
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Nascimento Filho E, Seixas MT, Mazzoni A, Weckx LLM. Osteomas exofíticos múltiplos de ossos craniofaciais não associados à Síndrome de Gardner: relato de caso. ACTA ACUST UNITED AC 2004. [DOI: 10.1590/s0034-72992004000600023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Osteomas exofíticos são protuberâncias de osso maduro que necessitam ser cuidadosamente diferenciados de outras lesões. Os autores apresentam relato de paciente do sexo masculino, com 44 anos de idade, apresentando osteomas exofíticos múltiplos localizados na região vestíbulo-maxilar em ambos os lados, região de pré-molares e molares não associados à Síndrome de Gardner.
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Herrmann SM, Adler YD, Schmidt-Petersen K, Nicaud V, Morrison C, Paul M, Zouboulis CC. The concomitant occurrence of multiple epidermal cysts, osteomas and thyroid gland nodules is not diagnostic for Gardner syndrome in the absence of intestinal polyposis: a clinical and genetic report. Br J Dermatol 2003; 149:877-83. [PMID: 14616385 DOI: 10.1046/j.1365-2133.2003.05640.x] [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: 11/20/2022]
Abstract
Gardner syndrome, a phenotypic variant of familial adenomatous polyposis, is characterized by the classical clinical triad of skin and soft tissue tumours, osteomas and intestinal polyposis, but disease patterns with pairs of these findings have also been reported. Different mutations in the adenomatous polyposis coli (APC) gene have been shown to be associated with Gardner syndrome disease phenotypes. A 36-year-old patient presented with multiple epidermal cysts on the face, left ear lobe and neck, and the possible diagnosis of Gardner syndrome was based on the additional findings of two classical osteomas in the left radius and ulna and a cold non-malignant nodule of the thyroid gland. Intestinal polyposis was lacking at the time of examination. Major deletions but not microdeletions were excluded by a cytogenetic analysis with 650 chromosomal bands per haploid set. Systematic sequencing of the entire coding region of the APC gene (> 8500 bp) of the patient and five healthy controls was also performed. As a results, new APC gene polymorphisms were identified in exons 13 [A545A (A/G)] and 15 [G1678G (A/G), S1756S (G/T), P1960P (A/G)]. We also detected D1822V (A/T) which has recently been reported to be potentially related to colorectal carcinoma, and genotyped 194 randomly chosen healthy individuals from the Glasgow area for this as well as for the above variants in exons 13 and 15. Interestingly, of the 194 controls, 112 carried the DD (57.7%), 71 the DV (36.6%), and the remaining 11 (5.7%), including our patient, the VV genotype. It is therefore unlikely that APC D1822V serves as an important marker for colorectal carcinoma. In conclusion, we failed to identify obvious germline candidate mutations in > 8500 bp of the coding region of the APC gene in a patient with multiple epidermal cysts, osteomas and a thyroid gland nodule; major chromosomal deletions were excluded. Therefore, we assume that only the presence of intestinal polyposis is a marker for Gardner syndrome.
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Affiliation(s)
- S-M Herrmann
- Institute of Clinical Pharmacology and Toxicology, Department of Clinical Pharmacology, University Medical Center Benjamin Franklin, Freie Universität Berlin, Fabeckstrasse 60-62, 14195 Berlin, Germany
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White DK, Street CC, Jenkins WS, Clark AR, Ford JE. Panoramic radiograph in pathology. Atlas Oral Maxillofac Surg Clin North Am 2003; 11:1-53. [PMID: 12725098 DOI: 10.1016/s1061-3315(02)00012-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Dean K White
- Division of Oral and Maxillofacial Pathology, College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40536-0298, USA.
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Wehrli BM, Weiss SW, Yandow S, Coffin CM. Gardner-associated fibromas (GAF) in young patients: a distinct fibrous lesion that identifies unsuspected Gardner syndrome and risk for fibromatosis. Am J Surg Pathol 2001; 25:645-51. [PMID: 11342777 DOI: 10.1097/00000478-200105000-00012] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Gardner syndrome (GS), caused by mutations in the adenomatous polyposis coli (APC) gene, is characterized by polyposis coli, osteomas, and various soft-tissue tumors. If undetected or untreated, virtually all patients develop colonic carcinoma at a young age. Early detection, while essential, can be difficult because of attenuated phenotypes or spontaneous mutations. We present the clinicopathologic features of 11 identical fibromatous lesions that we have termed Gardner-associated fibroma (GAF), which not only appear to be a part of the spectrum of lesions associated with GS but, in some cases, represent the sentinel event leading to its detection. The GAFs occurred in 11 patients (5 boys and 6 girls; age range, 3 months-14 years), were solitary (n = 7) or multiple (n = 4), and occurred in the superficial and deep soft tissues of the paraspinal region (n = 7), back (n = 3), face (n = 2), scalp (n = 2), chest wall (n = 2), thigh (n = 1), neck (n = 1), and flank (n = 1). Histologically, GAFs resemble nuchal-type fibromas (NFs), consisting of thick, haphazardly arranged collagen bundles between which are found occasional bland fibroblasts, and having margins that frequently engulf surrounding structures including adjacent fat, muscle and nerves. After surgical excision, four patients developed recurrences that were classic desmoid fibromatoses (DFs). In one patient with multiple GAFs, one lesion had the features of GAF and DF in the absence of surgical trauma. A family history of GS or polyposis (n = 6) or DF (n = 1) was known at the time of surgery in seven patients. In three patients, the diagnosis of GAF resulted in the diagnosis of unsuspected APC in older family members, with the detection of an occult colonic adenocarcinoma in one parent. In the family of the remaining patient, no stigmata of GS were present. Genetic analysis of this child was performed to investigate the presence of a spontaneous (new) mutation; however, no abnormalities were detected. The significance of GAF is that it serves as a sentinel event for identifying GS kindreds, including those with a high risk for the development of DF, and it may potentially identify children with spontaneous mutations of the APC gene. Because NFs and GAFs resemble one another, we suggest that a subset of NF occurring in multiple sites, unusual locations, or children may be GAF.
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Affiliation(s)
- B M Wehrli
- Department of Pathology, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
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Chaudhry SI, Tappuni AR, Challacombe SJ. Multiple maxillary and mandibular exostoses associated with multiple dermatofibromas: a case report. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 89:319-22. [PMID: 10710457 DOI: 10.1016/s1079-2104(00)70096-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Exostoses of the maxilla and mandible are nodular protuberances of mature bone that need to be accurately distinguished from other more diagnostically significant lesions, notably exosteal osteomas. Multiple dermatofibromas are rare and may be associated with altered immune function. We report the case of an otherwise healthy 47-year-old woman who was first seen with multiple maxillary and mandibular exostoses associated with multiple dermatofibromas. This association has not been previously reported.
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Affiliation(s)
- S I Chaudhry
- Department of Oral Medicine and Pathology, GKT Dental Institute, Guy's Hospital, London, England
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Lew D, DeWitt A, Hicks RJ, Cavalcanti MG. Osteomas of the condyle associated with Gardner's syndrome causing limited mandibular movement. J Oral Maxillofac Surg 1999; 57:1004-9. [PMID: 10437730 DOI: 10.1016/s0278-2391(99)90026-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- D Lew
- Department of Oral and Maxillofacial Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
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Hamilton SR, Liu B, Parsons RE, Papadopoulos N, Jen J, Powell SM, Krush AJ, Berk T, Cohen Z, Tetu B. The molecular basis of Turcot's syndrome. N Engl J Med 1995; 332:839-47. [PMID: 7661930 DOI: 10.1056/nejm199503303321302] [Citation(s) in RCA: 810] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Turcot's syndrome is characterized clinically by the concurrence of a primary brain tumor and multiple colorectal adenomas. We attempted to define the syndrome at the molecular level. METHODS Fourteen families with Turcot's syndrome identified in two registries and the family originally described by Turcot and colleagues were studied. Germ-line mutations in the adenomatous polyposis coli (APC) gene characteristic of familial adenomatous polyposis were evaluated, as well as DNA replication errors and germline mutations in nucleotide mismatch-repair genes characteristic of hereditary nonpolyposis colorectal cancer. In addition, a formal risk analysis for brain tumors in familial adenomatous polyposis was performed with a registry data base. RESULTS Genetic abnormalities were identified in 13 of the 14 registry families. Germ-line APC mutations were detected in 10. The predominant brain tumor in these 10 families was medulloblastoma (11 of 14 patients, or 79 percent), and the relative risk of cerebellar medulloblastoma in patients with familial adenomatous polyposis was 92 times that in the general population (95 percent confidence interval, 29 to 269; P < 0.001). In contrast, the type of brain tumor in the other four families was glioblastoma multiforme. The glioblastomas and colorectal tumors in three of these families and in the original family studied by Turcot had replication errors characteristic of hereditary nonpolyposis colorectal cancer. In addition, germ-line mutations in the mismatch-repair genes hMLH1 or hPMS2 were found in two families. CONCLUSIONS The association between brain tumors and multiple colorectal adenomas can result from two distinct types of germ-line defects: mutation of the APC gene or mutation of a mismatch-repair gene. Molecular diagnosis may contribute to the appropriate care of affected patients.
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Affiliation(s)
- S R Hamilton
- Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205-2196
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Bisgaard ML, Fenger K, Bülow S, Niebuhr E, Mohr J. Familial adenomatous polyposis (FAP): frequency, penetrance, and mutation rate. Hum Mutat 1994; 3:121-5. [PMID: 8199592 DOI: 10.1002/humu.1380030206] [Citation(s) in RCA: 275] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The nationwide Danish polyposis register includes all known Danish cases of familial adenomatous polyposis (FAP) and their relatives. By identifying all FAP patients born between 1920 and 1949, we found the frequency of the disease to be 1 in 13,528. By comparing the number of affected and nonaffected offspring born to affected parents during the same period we found the penetrance of the disease for inherited cases to be close to 100% at the age of 40 years. The mutation rate found by the direct method was 9 mutations per million gametes per generation and the proportion of new mutants was estimated to 25%. Fitness for patients between 15 and 29 years was found close to one, while for patients older than 30 the fitness was reduced, but increasing during the three decades (from 0.44 to 0.71) probably because treatment became more widespread and efficient. As we have used the overall fitness in the period, 0.87, to estimate the mutation rate by the indirect method, we found a lower value than by the direct method, namely 5 mutations per million gametes per generation.
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Affiliation(s)
- M L Bisgaard
- Department of Medical Biochemistry and Genetics, University of Copenhagen, Denmark
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Heinemann MH, Baker RH, Miller HH, DeCosse JJ. Familial polyposis coli: the spectrum of ocular and other extracolonic manifestations. Graefes Arch Clin Exp Ophthalmol 1991; 229:213-8. [PMID: 1651277 DOI: 10.1007/bf00167870] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Familial polyposis coli (FPC) is hereditary condition that conveys a virtual 100% risk for the development of colon cancer in the untreated patient. A total of 56 patients with FPC underwent complete ophthalmic examination. Highly pleomorphic pigmented retinal lesions were identified bilaterally in 52% (n = 29) and unilaterally in 14% (n = 8) of our subjects. In all, 33 patients had one or more extracolonic expressions associated with FPC, including desmoids, osteomas, epidermoid cysts, lipomas, fibromas, and upper gastrointestinal tract polyps. In 15 patients, pigmented fundus lesions were the only extracolonic manifestations. No significant association between eye findings and other extracolonic manifestations could be established. The presence or absence of pigmented fundus lesions was found to cluster within families. Pigmented fundus lesions are probably a variably penetrant expression of the polyposis gene and do not appear to be specifically associated with subgroups of inherited polyposis syndromes such as Gardner's syndrome.
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Affiliation(s)
- M H Heinemann
- Department of Ophthalmology, Cornell University Medical College, New York NY 10021
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Halata MS, Miller J, Stone RK. Gardner syndrome. Early presentation with a desmoid tumor. Discovery of multiple colonic polyps. Clin Pediatr (Phila) 1989; 28:538-40. [PMID: 2805561 DOI: 10.1177/000992288902801111] [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: 01/02/2023]
Abstract
A 14-year-old patient who was eventually found to have Gardner syndrome initially presented at the age of 3 years with a desmoid tumor involving the scalp. A careful review of the family history revealed a high incidence of colonic cancer, which prompted endoscopic evaluation of the patient. The discovery of adenomatous polyps in the colon confirmed the diagnosis of Gardner syndrome. In patients with hard or soft tissue tumors, the possibility of Gardner syndrome should be kept in mind, and a thorough family history taken. Early diagnosis may prevent malignant transformation of colonic polyps.
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Affiliation(s)
- M S Halata
- Department of Pediatrics, New York Medical College, Metropolitan Hospital Center, New York, New York 10029
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Gardner EJ, Woodward SR, Hughes JP. Evaluation of chromosomal diagnosis for hereditary adenomatosis of the colorectum. CANCER GENETICS AND CYTOGENETICS 1985; 15:321-34. [PMID: 3971323 DOI: 10.1016/0165-4608(85)90177-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Hereditary adenomatosis, particularly familial polyposis coli (FPC) and Gardner's syndrome (GS), has been investigated from family pedigrees and chromosomal markers for precancer and cancer. FPC and GS are much alike in phenotypes. Studies are in progress to determine if the two adenomatous diseases are controlled by the same DNA sequence. Chromosome numerical and structural instability is a good diagnostic criterion for hereditary adenomatous diseases where risk factors are already determined to the level of 0.5 probability from pedigree analysis. This has been applied successfully at the pediatric age level to identify family members who carry the gene but have no adenomas in the colorectum. Sister chromatid exchange (SCE) did not distinguish plasma samples from FPC, GS, or solitary adenoma patients form each other or from controls with no adenomas. SCE did distinguish invasive from recurrent and noninvasive cancer. The chromosome #2 polymorphism observed at 2q-21.3 has not been confirmed as a deletion, but is under investigation with more refined methods.
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Lewis RA, Crowder WE, Eierman LA, Nussbaum RL, Ferrell RE. The Gardner syndrome. Significance of ocular features. Ophthalmology 1984; 91:916-25. [PMID: 6493700 DOI: 10.1016/s0161-6420(84)34213-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Gardner syndrome is a dominantly inherited familial cancer syndrome characterized by intestinal polyposis, bony hamartomata, and various soft tissue tumors. The risk of malignancy during adult life is essentially 100%, but as yet no phenotypic marker nor biochemical or serological linkage have been useful to identify the presence of the gene in early life. We studied three families in which multiple and bilateral patches of congenital hypertrophy of the retinal pigment epithelium are related uniquely to other phenotypic features of the Gardner gene. This readily identifiable characteristic may be useful to identify early in life individuals at risk for malignancy. We also suggest that the Gardner syndrome may be genetically heterogeneous.
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Henson P, Fornace AJ, Little JB. Normal repair of ultraviolet-induced DNA damage in a hypersensitive strain of fibroblasts from a patient with Gardner's syndrome. Mutat Res 1983; 112:383-95. [PMID: 6656799 DOI: 10.1016/0167-8817(83)90031-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Gardner's syndrome is an autosomal dominant disorder that predisposes to cancer of the large intestine and to other tumors. We have previously demonstrated that fibroblasts from a patient with this disease are hypersensitive to the cytotoxic effects of ultraviolet light. In this report we have measured several parameters of the repair of ultraviolet light-induced DNA damage in an attempt to identify a defect responsible for the hypersensitivity. We have found the excision rate of pyrimidine dimers, the host cell reactivation of UV-irradiated herpes simplex virus, the induction and rejoining of DNA single strand breaks and the response of semi-conservative DNA replication to UV-irradiation to be in all cases indistinguishable from such phenomena in a variety of normal cells.
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Abstract
In recent years, a number of comprehensive reviews have been written on inherited intestinal polyposis syndromes (1-7), but none has dealt specifically with Gardner's syndrome and none has focused on basic research being carried out in an attempt to understand this syndrome and to improve the medical management of affected patients. A better understanding of this rare genetic disorder is essential for surgeons, gastroenterologists, cancer researchers, and geneticists alike. To the clinician, it poses difficult challenges in management; to the cancer researcher, it presents a rare opportunity to study very early premalignant transformations; and to the geneticist, it poses exciting questions at the cellular, chromosomal, and molecular levels.
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Blair NP, Trempe CL. Hypertrophy of the retinal pigment epithelium associated with Gardner's syndrome. Am J Ophthalmol 1980; 90:661-7. [PMID: 7446647 DOI: 10.1016/s0002-9394(14)75133-5] [Citation(s) in RCA: 145] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Congenital hypertrophy of the retinal pigment epithelium was seen in three affected members of a kindred with Gardner's syndrome. The latter consists of a triad of many intestinal polyps, hard-tissue abnormalities, and soft-tissue abnormalities. Although the appearance of the individual lesions in our patients was typical of hypertrophy of the retinal pigment epithelium, the following atypical features were present: multiple lesions per eye; bilateral occurrence; familial transmission; and association with systemic disease. Ophthalmoscopic examination can help identify children who are at risk of developing polyposis and carcinoma of the colon. In some instances, Gardner's syndrome may be diagnosed in a patient and his family as a result of observing the fundus lesions.
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Little JB, Nove J, Weichselbaum RR. Abnormal sensitivity of diploid skin fibroblasts from a family with gardner's syndrome to the lethal effects of X-irradiation, ultraviolet light and mitomycin-C. Mutat Res 1980; 70:241-50. [PMID: 7374661 DOI: 10.1016/0027-5107(80)90164-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Skin fibroblasts isolated from two members of the same family with the cancer-prone disease Gardner' Syndrome (intestinal polyposis, colon cancer, bone and soft tissue tumors) showed enhanced sensitivity to the lethal effects of X-irradiation, ultraviolet light and mitomycin-C. These cells showed no liquid-holding type recovery following UV-irradiation of confluent cultures, but were normal in their capacity for UV-induced unscheduled DNA synthesis. UV survival was not influenced by post-irradaiation incubation with caffeine.
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Pauli RM, Pauli ME, Hall JG. Gardner syndrome and periampullary malignancy. AMERICAN JOURNAL OF MEDICAL GENETICS 1980; 6:205-19. [PMID: 6999900 DOI: 10.1002/ajmg.1320060305] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In a family with colonic polyposis and the typical associated findings of Gardner syndrome (osteomas and soft-tissue tumors), two and possibly four of the affected members developed periampullary malignancy. A review indicates that individuals with Gardner syndrome may have a 100- to 200-fold increased risk of developing periampullary carcinoma when compared to the general population. While certain families and certain individuals (those with other duodenal involvement, males and those with all of the characteristics of Gardner syndrome expressed) may be most susceptible, all patients with Gardner syndrome should be periodically endoscopically evaluated for the presence of upper gastrointestinal tract disease.
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Keshgegian AA, Enterline HT. Gardner's syndrome with duodenal adenomas, gastric adenomyoma and thyroid papillary--follicular adenocarcinoma. Dis Colon Rectum 1978; 21:255-60. [PMID: 657934 DOI: 10.1007/bf02586699] [Citation(s) in RCA: 41] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A case of a woman with Gardner's syndrome, originally manifested by multiple adenomatous polyps of the colon, is presented. She underwent subtotal colectomy at 14 years of age. Over the next 15 years she had a composite odontoma, an impacted supernumerary tooth, two epidermal inclusion cysts, multicentric paillary-follicular adenocarcinoma of the thyroid, two tubulovillous adenomas of the duodenum in which argyrophilic cells were a prominent feature, and an adenomyoma of the gastric antrum. The presence of all of these lesions in one patient expands the spectrum of lesions seen with Gardner's syndrome and supports the concept of a generalized abnormality of growth regulation as the cause of the syndrome.
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Mathias JR, Smith WG. Mesenteric fibromatosis associated with familial polyposis. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1977; 22:741-4. [PMID: 879143 DOI: 10.1007/bf01078358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This patient represents the 25th case report of mesenteric fibromatosis in patients with Gardner's syndrome. Her family genealogy reveals polyposis of the colon in nine members in four generations. In addition, one member has papillary carcinoma of the thyroid and one has newly discovered osteomas. To our knowledge, this family may be the first to manifest this combination of extracolonic lesions with familial polyposis, and the case supports a single-gene etiology for the complete syndrome.
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Abstract
The Gardner syndrome is an autosomal dominant condition characterized by multiple polyposis of the colon, associated with various soft- and hard-tissue tumors. Our original kindred, first reported in the early 1950's has been updated and serves as the basis for a discussion of the penetrance and expressivity of the gene responsible for the syndrome. The family consists of 188 members spread over six generations, with 28 individuals clearly documented as having the syndrome. Using two different methods of calculating penetrance, the responsible gene was found to be fully penetrant. This observation was confirmed by an analysis of 160 additional sibships from the literature. This estimation of penetrance is considerably higher than has been previously reported. The expressivity of the gene, however, is quite variable, and this is illustrated using examples from both our kindred and the literature.
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McKusick VA. Genetics and large-bowel cancer. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1974; 19:954-8. [PMID: 4424663 DOI: 10.1007/bf01076222] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Smith WG, Kern BB. The nature of the mutation in familial multiple polyposis: papillary carcinoma of the thyroid, brain tumors, and familial multiple polyposis. Dis Colon Rectum 1973; 16:264-71. [PMID: 4720000 DOI: 10.1007/bf02587699] [Citation(s) in RCA: 66] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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