ACTA FAC MED NAISS 2010; 27 (2): 93-103 |
Review article
UDC: 616.3-006:616-056.7
Hereditary Hamartomatous Gastrointestinal Polyposis Syndrome
Vesna Živković1, Svetlana Pejović1,
Aleksandar Nagorni2, Bratislav Petrović2, Aleksandar
Petrović3, Ivan Ilić1
1Institute of Pathology, University of Niš Faculty of Medicine,
Serbia
2Clinic of Gastroenterology, University of Niš Faculty of Medicine, Serbia
3Institute of Histology and Embryology, University of Niš Faculty of Medicine, Serbia
SUMMARY
Hamartomas represent localized overgrowth of cells in the parts which are
normally associated with polyps, ie. mesenhimal, stromal, endodermal and
ectodermal elements. Hamartomatous polyposis syndromes carry a significant risk
of developing dysplasia, adenomas, gastrointestinal carcinomas, and pancreatic
carcinomas. These syndromes may be classified on the basis of whether they
represent hereditary syndromes or whether they occur on a sporadic basis. An
overlap has been noticed among some of the syndromes. There have been described
eight hereditary, and four non-hereditary hamartomatous poly pos syndromes.
Hereditary syndromes include: Hereditary juvenile polyposis syndrome, Cowden
syndrome, Bannayan-Ruvalcaba-Riley syndrome, Peutz-Jeghers syndrome, Nevus basal
cell syndrome, Hereditary mixed polyposis syndrome, Neurofibromathosis type 1,
and Multiple Endocrine Neoplasia type 2B. All of these syndromes are inherited
in an autosomal dominant fashion. Non-hereditary syndromes include:
Cronkhite-Canada syndrome, hyperplastic polyps, lymphoid polyposis, lymphomatous
polyposis. The diagnosis of these syndromes primarily remains a clinical
process. Treatment of these patients requires a coordinated multidisciplinary
approach which includes gastroenterology, pathology, dermatology, surgery,
oncology, and genetics.
Key words: hamartomatous polyps, juvenile polyps, Peutz-Jeghers syndrome,
Cowden syndrome, genetics