Document Detail


Mucocutaneous neuromas: an underrecognized manifestation of PTEN hamartoma-tumor syndrome.
MedLine Citation:
PMID:  16702501     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The spectrum of clinical findings associated with PTEN tumor suppressor gene germline mutations, referred to as PTEN hamartoma-tumor syndrome (PHTS), includes Cowden and Bannayan-Riley-Ruvalcaba syndromes. Although the skin is the ectodermal structure most often affected by these autosomal dominant genodermatoses, abnormalities of neural tissues are frequently observed. OBSERVATIONS: We describe a 5-year-old boy with macrocephaly, prominent corneal nerves, and progressive development of multiple painful, dome-shaped, translucent pink to skin-colored papules on the vermilion portion of the upper lip, fingers, palms, and shins. Histologic evaluation demonstrated dermal proliferation of well-demarcated nerve bundles associated with abundant mucin and surrounded by a distinct perineural sheath, findings diagnostic of a nonencapsulated neuroma. Genetic analysis revealed a novel heterozygous germline nonsense mutation in PTEN, predicted to result in a truncated PTEN protein. To our knowledge, this represents the first report of multiple neuromas as the sole mucocutaneous manifestation of PHTS. CONCLUSIONS: This article highlights neuromas as a cutaneous sign of PHTS, drawing attention to manifestations of PHTS in neural tissues of the skin, eye, gastrointestinal tract, and brain. Along with multiple endocrine neoplasia type 2B, PHTS should be considered in the differential diagnosis of multiple mucocutaneous neuromas, particularly those involving extrafacial sites.
Authors:
Julie V Schaffer; Hideko Kamino; Agnieszka Witkiewicz; Jennifer M McNiff; Seth J Orlow
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Archives of dermatology     Volume:  142     ISSN:  0003-987X     ISO Abbreviation:  Arch Dermatol     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-16     Completed Date:  2006-05-26     Revised Date:  2008-03-17    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  625-32     Citation Subset:  AIM; IM    
Affiliation:
Ronald O. Perelman Department of Dermatology and Departments of Pathology and Pediatrics, New York University School of Medicine, New York, USA. schafj04@med.nyu.edu
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MeSH Terms
Descriptor/Qualifier:
Child, Preschool
Diagnosis, Differential
Hamartoma Syndrome, Multiple / diagnosis*,  pathology
Hand
Humans
Leg
Lip
Male
Mutation
Neuroma / diagnosis*,  pathology
PTEN Phosphohydrolase / genetics
Skin Neoplasms / diagnosis*,  pathology
Chemical
Reg. No./Substance:
EC 3.1.3.48/PTEN protein, human; EC 3.1.3.67/PTEN Phosphohydrolase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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