Hamartomatous polyposis syndromes
1University of Iowa, Roy J. and Lucille A. Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242-2600, USA.
Insights
Hamartomatous polyposis syndromes, including juvenile polyposis and PTEN hamartoma tumor syndromes, involve gastrointestinal polyps. Early recognition and presymptomatic testing are crucial for managing these rare inherited and acquired disorders.
Area of Science:
- Gastroenterology
- Genetics
- Oncology
Background:
- Hamartomatous polyps were first described in 1957.
- Several syndromes are associated with hamartomatous polyps in the GI tract.
Purpose of the Study:
- To review hamartomatous polyposis syndromes.
- To discuss clinical aspects, molecular pathogenesis, affected systems, cancer risks, and management.
Main Methods:
- Literature review of hamartomatous polyposis syndromes.
- Synthesis of clinical, molecular, and management data.
Main Results:
- Identified syndromes include juvenile polyposis, Peutz-Jeghers, hereditary mixed polyposis, PTEN hamartoma tumor syndromes (Cowden, Bannayan-Riley-Ruvalcaba), and Cronkhite-Canada syndrome.
- These syndromes vary in inheritance patterns (autosomal dominant or acquired) and affect multiple organ systems.
Conclusions:
- Recognition of these syndromes is vital for preventing patient morbidity and mortality.
- Presymptomatic testing is recommended for at-risk individuals.
Abstract:
Since the histologic description of the hamartomatous polyp in 1957 by Horrilleno and colleagues, descriptions have appeared of several different syndromes with the propensity to develop these polyps in the upper and lower gastrointestinal tracts. These syndromes include juvenile polyposis, Peutz-Jeghers syndrome, hereditary mixed polyposis syndrome, and the phosphatase and tensin homolog gene (PTEN) hamartoma tumor syndromes (Cowden and Bannayan-Riley-Ruvalcaba syndromes), which are autosomal-dominantly inherited, and Cronkhite-Canada syndrome, which is acquired. This article reviews the clinical aspects, the molecular pathogenesis, the affected organ systems, the risks of cancer, and the management of these hamartomatous polyposis syndromes. Although the incidence of these syndromes is low, it is important for clinicians to recognize these disorders to prevent morbidity and mortality in these patients, and to perform presymptomatic testing in patients at risk.
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