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Solitary Peutz-Jeghers type hamartomatous polyps in the duodenum are not always associated with a low risk of cancer: two case reports.

Sekino Y, Inamori M, Hirai M, Suzuki K, Tsuzawa K, Akimoto K, Takahata A, Fujisawa N, Saito K, Tsunemi A, Tanaka M, Iida H, Sakamoto Y, Takahashi H, Koide T, Tokoro C, Abe Y, Nakajima A, Maeda S, Koyama S - J Med Case Rep (2011)

Bottom Line: In case one, we describe an 84-year-old Japanese man with a 14 mm duodenal polyp.In case two, we describe a 76-year-old Japanese man who had been treated for prostate, rectal and lung cancer.Upper gastrointestinal endoscopy revealed a duodenal polyp measuring 15 mm in diameter.

View Article: PubMed Central - HTML - PubMed

Affiliation: Gastroenterology Division, Yokohama City University School of Medicine, 3-9 Fukuura Kanazawa-ku, Yokohama, 236-0004, Japan. inamorim@med.yokohama-cu.ac.jp.

ABSTRACT

Introduction: A hamartomatous polyp without associated mucocutaneous pigmentation or a family history of Peutz-Jeghers Syndrome is diagnosed as a solitary Peutz-Jeghers type hamartomatous polyp. As compared with Peutz-Jeghers Syndrome, Peutz-Jeghers type hamartomatous polyps are diagnosed with a lower risk of cancer and are regarded as a different disorder.

Case presentation: In case one, we describe an 84-year-old Japanese man with a 14 mm duodenal polyp. Endoscopic mucosal resection was performed and histological examination showed findings suggestive of a hamartomatous polyp with a focus of well-differentiated adenocarcinoma. In case two, we describe a 76-year-old Japanese man who had been treated for prostate, rectal and lung cancer. Upper gastrointestinal endoscopy revealed a duodenal polyp measuring 15 mm in diameter. Endoscopic mucosal resection was performed, and histological examination showed findings suggestive of a hamartomatous polyp. Liver and thyroid cancers were found after the endoscopic treatment.

Conclusion: Although duodenal solitary hamartomatous polyps are associated with a lower risk of cancer, four patients, including our cases, have been diagnosed with cancerous polyps. Patients with duodenal solitary hamartomatous polyps should be treated by endoscopic or surgical resection and need whole-body screening.

No MeSH data available.


Related in: MedlinePlus

Histological examination showed findings suggestive of a hamartoma: branching bundles of smooth muscle fibers covered by hyperplastic duodenal mucosa, with a focus of well-differentiated adenocarcinoma. Hematoxylin and eosin staining (objective 10 ×).
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Figure 2: Histological examination showed findings suggestive of a hamartoma: branching bundles of smooth muscle fibers covered by hyperplastic duodenal mucosa, with a focus of well-differentiated adenocarcinoma. Hematoxylin and eosin staining (objective 10 ×).

Mentions: Case 1 is an 84-year-old Japanese man with previous medical history of hypertension, chronic hepatitis C infection, idiopathic thrombocytopenic purpura and colon polyps (tubular adenoma and tubulovillous adenoma). He had no mucocutaneous pigmentation or family history of PJS. An upper gastrointestinal endoscopy revealed a lobular polyp measuring 14 mm in diameter, in the superior duodenal angle (Figure 1). Endoscopic mucosal resection was performed without complication and histological examination showed findings suggestive of a hamartomatous polyp--branching bundles of smooth muscle fibers covered by hyperplastic duodenal mucosa--with a focus of well-differentiated adenocarcinoma (Figure 2). A colonoscopy and small-intestinal follow-through showed no other polyps.


Solitary Peutz-Jeghers type hamartomatous polyps in the duodenum are not always associated with a low risk of cancer: two case reports.

Sekino Y, Inamori M, Hirai M, Suzuki K, Tsuzawa K, Akimoto K, Takahata A, Fujisawa N, Saito K, Tsunemi A, Tanaka M, Iida H, Sakamoto Y, Takahashi H, Koide T, Tokoro C, Abe Y, Nakajima A, Maeda S, Koyama S - J Med Case Rep (2011)

Histological examination showed findings suggestive of a hamartoma: branching bundles of smooth muscle fibers covered by hyperplastic duodenal mucosa, with a focus of well-differentiated adenocarcinoma. Hematoxylin and eosin staining (objective 10 ×).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3141699&req=5

Figure 2: Histological examination showed findings suggestive of a hamartoma: branching bundles of smooth muscle fibers covered by hyperplastic duodenal mucosa, with a focus of well-differentiated adenocarcinoma. Hematoxylin and eosin staining (objective 10 ×).
Mentions: Case 1 is an 84-year-old Japanese man with previous medical history of hypertension, chronic hepatitis C infection, idiopathic thrombocytopenic purpura and colon polyps (tubular adenoma and tubulovillous adenoma). He had no mucocutaneous pigmentation or family history of PJS. An upper gastrointestinal endoscopy revealed a lobular polyp measuring 14 mm in diameter, in the superior duodenal angle (Figure 1). Endoscopic mucosal resection was performed without complication and histological examination showed findings suggestive of a hamartomatous polyp--branching bundles of smooth muscle fibers covered by hyperplastic duodenal mucosa--with a focus of well-differentiated adenocarcinoma (Figure 2). A colonoscopy and small-intestinal follow-through showed no other polyps.

Bottom Line: In case one, we describe an 84-year-old Japanese man with a 14 mm duodenal polyp.In case two, we describe a 76-year-old Japanese man who had been treated for prostate, rectal and lung cancer.Upper gastrointestinal endoscopy revealed a duodenal polyp measuring 15 mm in diameter.

View Article: PubMed Central - HTML - PubMed

Affiliation: Gastroenterology Division, Yokohama City University School of Medicine, 3-9 Fukuura Kanazawa-ku, Yokohama, 236-0004, Japan. inamorim@med.yokohama-cu.ac.jp.

ABSTRACT

Introduction: A hamartomatous polyp without associated mucocutaneous pigmentation or a family history of Peutz-Jeghers Syndrome is diagnosed as a solitary Peutz-Jeghers type hamartomatous polyp. As compared with Peutz-Jeghers Syndrome, Peutz-Jeghers type hamartomatous polyps are diagnosed with a lower risk of cancer and are regarded as a different disorder.

Case presentation: In case one, we describe an 84-year-old Japanese man with a 14 mm duodenal polyp. Endoscopic mucosal resection was performed and histological examination showed findings suggestive of a hamartomatous polyp with a focus of well-differentiated adenocarcinoma. In case two, we describe a 76-year-old Japanese man who had been treated for prostate, rectal and lung cancer. Upper gastrointestinal endoscopy revealed a duodenal polyp measuring 15 mm in diameter. Endoscopic mucosal resection was performed, and histological examination showed findings suggestive of a hamartomatous polyp. Liver and thyroid cancers were found after the endoscopic treatment.

Conclusion: Although duodenal solitary hamartomatous polyps are associated with a lower risk of cancer, four patients, including our cases, have been diagnosed with cancerous polyps. Patients with duodenal solitary hamartomatous polyps should be treated by endoscopic or surgical resection and need whole-body screening.

No MeSH data available.


Related in: MedlinePlus