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Oral hyperpigmented lesions--a case study.

Siew Kim Kwa¹, Esha Das Gupta

¹Department of Family Medicine, International Medical University, Seremban, Negri Sembilan, Malaysia. kwaskim2@yahoo.co.uk

Australian Family Physician

|July 5, 2013

Summary

A 58-year-old woman with hypertension, diabetes, and dyslipidemia presented with hyperpigmented macules. These lesions, present since her 40s, along with a family history of gastrointestinal cancers, suggest a potential genetic predisposition.

Area of Science:

Gastroenterology
Dermatology
Genetics

Background:

The patient is a 58-year-old overweight female with a history of hypertension, diabetes, and dyslipidemia.
She presented for routine follow-up of her chronic conditions.

Observation:

The patient exhibited hyperpigmented brown macules on the inner surface of her lower lip and buccal mucosa.
These oral lesions were first noticed in her 40s.

Findings:

The patient's mother died at 58 from metastatic gastric cancer.
Her brother died at 45 from colon cancer with liver and lung metastases.
The combination of oral pigmentation and a strong family history of gastrointestinal cancers raises suspicion for a hereditary cancer syndrome.

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Implications:

Early recognition of oral signs like Peutz-Jeghers Syndrome (PJS) related pigmentation is crucial.
Genetic counseling and screening for gastrointestinal cancers are recommended for individuals with such findings and family history.
This case highlights the importance of a thorough family history and physical examination for identifying potential hereditary cancer syndromes.