Increased risk of cancer in the Peutz–Jeghers syndrome

FM Giardiello, SB Welsh, SR Hamilton… - … England Journal of …, 1987 - Mass Medical Soc
FM Giardiello, SB Welsh, SR Hamilton, GJA Offerhaus, AM Gittelsohn, SV Booker, AJ Krush…
New England Journal of Medicine, 1987Mass Medical Soc
Abstract The Peutz–Jeghers syndrome is an autosomal dominant hereditary disease
characterized by hamartomatous polyps of the gastrointestinal tract and by mucocutaneous
melanin deposits. The frequency of cancer in this syndrome has not been studied
extensively. Therefore, we investigated 31 patients with the Peutz–Jeghers syndrome who
were followed from 1973 to 1985. All cases of cancer were verified by histopathological
review. Cancer developed in 15 of the 31 patients (48 percent)—gastrointestinal carcinomas …
Abstract
The Peutz–Jeghers syndrome is an autosomal dominant hereditary disease characterized by hamartomatous polyps of the gastrointestinal tract and by mucocutaneous melanin deposits. The frequency of cancer in this syndrome has not been studied extensively. Therefore, we investigated 31 patients with the Peutz–Jeghers syndrome who were followed from 1973 to 1985. All cases of cancer were verified by histopathological review.
Cancer developed in 15 of the 31 patients (48 percent) — gastrointestinal carcinomas in 4, nongastrointestinal carcinomas in 10, and multiple myeloma In 1. In addition, adenomatous polyps of the stomach and colon occurred in three other patients. The cancers were diagnosed when the patients were relatively young, but after the Peutz–Jeghers syndrome had been diagnosed (interval between diagnoses, 25±20 years; range, 1 to 64). According to relative-risk analysis, the observed development of cancer in the patients with the syndrome was 18 times greater than expected in the general population (P<0.0001).
Our results suggest that patients with the Peutz–Jeghers syndrome have an increased risk for the development of cancer at gastrointestinal and nongastrointestinal sites. (N Engl J Med 1987; 316:1511–4.)
The New England Journal Of Medicine