Assuntos
Síndrome de Muir-Torre/sangue , Neoplasias Primárias Múltiplas/sangue , Fator de Crescimento Transformador beta/sangue , Idoso , Neoplasias do Colo , Humanos , Imuno-Histoquímica , Masculino , Síndrome de Muir-Torre/metabolismo , Síndrome de Muir-Torre/patologia , Síndrome de Muir-Torre/fisiopatologia , Recidiva Local de Neoplasia , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/fisiopatologia , Proteínas Serina-Treonina Quinases/metabolismo , Receptor do Fator de Crescimento Transformador beta Tipo II , Receptores de Fatores de Crescimento Transformadores beta/metabolismoAssuntos
Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Muir-Torre/complicações , Síndrome de Muir-Torre/diagnóstico , Síndrome de Muir-Torre/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias das Glândulas Sebáceas/complicações , Dermatoses Faciais/complicações , Dermatoses Faciais/patologia , Síndrome de Muir-Torre/fisiopatologia , Neoplasias das Glândulas Sebáceas/diagnóstico , Glândulas Sebáceas/anatomia & histologia , Glândulas Sebáceas/patologiaRESUMO
Mutations in mismatch repair genes lead to Lynch Syndrome, the most common form of inherited colorectal cancer. In this report, we describe a novel complex germline mutation c.[1601_1661+92dup; 1591_1611del] of the mismatch repair gene, MSH2. This mutation, which segregates with the disease phenotype, was discovered in a Lynch syndrome kindred that also shows a history of the Muir-Torre syndrome. Interestingly, several tumors from this family displayed microsatellite instability, a hallmark of Lynch syndrome tumors but no consistent, concomitant loss of MSH2 protein expression. In addition, a subset of tumors showed neither prototypical feature of microsatellite instability nor immunohistochemistry deficiency, highlighting the importance of a detailed molecular analysis of rare genetic alterations. This mutation and the atypical clinical manifestations observed underscore the genetic complexity underlying Lynch syndrome, and the importance of comprehensive molecular screening in the diagnosis and early detection of colorectal and other associated cancers.