BACKGROUND:
Muir-Torre
syndrome (MTS) is an autosomal dominant syndrome characterized by
neoplasms of the
sebaceous gland or keratoacanthomas, in addition to
visceral malignancies. Cerebral neoplasms in patients with hereditary
nonpolyposis colorectal cancer (HNPCC) or familial adenomatous polyposis
suffer from Turcot's syndrome. Genetic mutations in MutS homolog
(MSH)-2, MutL homolog (MLH)-1, and MutS homolog (MSH)-6 DNA mismatch
repair genes are the most common in MTS with
MSH-2 being the most
predominant. In HNPCC MLH-1 and MSH-2 mutations are approximately equal
in prevalence.
CASE DESCRIPTION:
We present the case of a
58-year-old male with a prior history of being treated for
colonic
adenocarcinoma and skin lesions leading to a diagnosis of MTS. The
patient later developed a World Health Organization (WHO)
grade 4 glioma
requiring surgical resection. Pathology revealed mutations in
MSH-2 and
MSH-6 mismatch repair genes.
CONCLUSIONS:
This case
represents the first report of Turcot's and MTS with extensive molecular
testing on the cerebral neoplasm demonstrating a molecular relationship
between Turcot's and MTS and only the second published report of
simultaneous Turcot's and MTS.
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