Solitary duodenal hamartomatous polyp with malignant transformation: Report of a case

Abstract

A solitary duodenal hamartomatous polyp is rare and it is considered to be either a variant of Peutz-Jeghers syndrome (PJS) or a separate entity. Patients do not have cutaneous manifestations and have only one hamartomatous polyp. The presentation is nonspecific and it resembles common conditions, such as a peptic ulcer disease. Most are incidentally diagnosed during endoscopy for other indications. Malignant transformation has been reported. This report describes the case of a 46-year-old man who presented with chronic intermittent abdominal pain. The initial endoscopy showed an abnormal twisting of the duodenum with a dilated duodenum. He was later diagnosed to have a solitary duodenal hamartomatous polyp with malignant transformation, which was treated by surgery. A review of the literature on the pertinent cases of this type of lesion is also presented.

Adult Intussusception in Patients with Peutz-Jeghers Syndrome: Case Series and Review of Literature

“…Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant disorder resulting from mutation of the serine/threonine kinase 11 which is a tumor suppressor gene located on chromosome 19p13.3 [18]. It is estimated that about half of the patients with PJS will have intussusception; because of the large size of the polyps and its pedunculated nature, that requires surgery.…”

Endoscopic snare papillectomy for a solitary Peutz-Jeghers-type polyp in the duodenum with ingrowth into the common bile duct: Case report

“…A search of case reports on the MEDLINE database up to 2014 using the terms "solitary", "duodenum", and "hamartomatous polyp", but without PJS, identified 19 patients in 13 studies published in English with solitary-PJ type polyps in the duodenum, including the patient described here [2,[5][6][7][8][9][10][11][12][13][14][15] (Table 1). Age at onset ranged from 23-89 years (mean ± SD: 60.3 ± 20.1 years).…”

“…Duodenal solitary PJ-type hamartomatous polyp is usually diagnosed incidentally during gastroduodenal endoscopy. Its presentation is nonspecific and resembles common conditions, such as peptic ulcer disease [13] . Our patient was the first to report acute cholangitis and jaundice as the chief complaints.…”

Unusual Presentation of Intussusception of the Small Bowel with Peutz Jeghers Syndrome: Report of a Case

“…The cause of PJS appears to be a germline mutation of the STK11/LKB1 (serine/threonine kinase 11) tumour suppressor gene in most of the cases (70-80%) [2,3]. Its incidence has been estimated to be one in 120000 births [4].…”