Solitary Peutz-Jeghers Type Colorectal Polyp with Hamartoma-adenoma-carcinoma Sequence in a Non-Peutz-Jeghers Syndrome Patient

Abstract

A Peutz-Jeghers P-J type polyp is a hamartomatous polyp that occurs in patients with P-J syndrome, but is rarely found as a solitary polyp in non-P-J syndrome patients 1 . There have been some reports of polyposis and cancerous transformation in patients with P-J syndrome, but few reports of solitary P-J type polyps containing cancer foci 2, 3 . We report here a rare case of a colorectal P-J type polyp showing the hamartoma-adenoma-carcinoma sequence in a non-Peutz-Jeghers syndrome patient. Case ReportA 48-year-old woman was admitted to our hospital for medical examination. Colonoscopy Abstract : Peutz-Jeghers P-J syndrome is an inherited disorder characterized by multiple hamartomatous gastrointestinal polyps, mucocutaneous pigmentation, and an increased risk of both digestive tract and non-digestive tract cancers. P-J type polyps are characteristic of P-J syndrome but rarely present as solitary polyps. Though cancerous lesions frequently develop from polyposis in P-J syndrome, reports of malignancy in solitary colorectal P-J type polyps are rare ; our literature search identi ed only two examples. This report describes a non-Peutz-Jeghers syndrome patient with a solitary P-J type polyp showing the hamartoma-adenoma-carcinoma sequence.

Narrow‐band imaging with magnification for the diagnosis of colorectal adenoma in a patient with Cronkhite‐Canada syndrome

“…Although it is beyond the scope of this case report to verify each possibility, Arima et al. reported a case of a colorectal Peutz‐Jeghers type polyp with hamartoma‐adenoma‐carcinoma sequence in a non‐Peutz‐Jeghers syndrome patient 10 . A disease trajectory along the hamartoma‐adenoma‐carcinoma sequence has thus been suggested to explain the cancerous transformation in hamartomatous polyps.…”

“…Although it is beyond the scope of this case report to verify each possibility, Arima et al reported a case of a colorectal Peutz-Jeghers type polyp with hamartoma-adenoma-carcinoma sequence in a non-Peutz-Jeghers syndrome patient. 10 A disease trajectory along the hamartoma-adenoma-carcinoma sequence has thus been suggested to explain the cancerous transformation in hamartomatous polyps. In addition, the rate of CCS-related cancer was reported to be lower in patients with sustained endoscopic remission, compared to those with relapses or nonresponders.…”

A giant and extensive solitary Peutz–Jeghers-type polyp in the antrum of stomach

“…This supported the hypothesis that both solitary Peutz–Jeghers-type polyp and PJS are associated with the risk of cancer. Arima [ 23 ] reported a case of solitary Peutz–Jeghers-type polyp with the hamartoma–adenoma–carcinoma sequence. Limaiem et al [ 24 ] reported a case of solitary rectal Peutz–Jeghers-type polyp with adenomatous transformation.…”