Abstract
Background Clinical characteristics and prognosis of patients with a solitary Peutz-Jeghers polyp (PJP) have not been fully investigated. Methods Solitary PJP was diagnosed when a single hamartomatous lesion was identified in the gastrointestinal tract of patients without mucocutaneous pigmentation or a family history of Peutz-Jeghers syndrome. We retrospectively reviewed 51 patients (32 men and 19 women) with a solitary PJP and analyzed the sex, age at diagnosis, endoscopic features, and outcomes in this patient group. The STK11/LKB1 germline mutation was not investigated in any of the patients. Results The mean age of the 51 patients was 66.1 years. The polyp was found in the duodenum (N = 10), jejunum (N = 2), cecum (N = 2), transverse colon (N = 5), sigmoid colon (N = 21), or rectum (N = 11). Most of the polyps presented as a pedunculated lesion (N = 40), followed by semipedunculated (N = 9) and sessile (N = 2) morphologies. The mean size of a solitary PJP was 15.6 mm (range: 5 to 33 mm). During a mean endoscopic follow-up period of 4.5 years (range: 0.1 to 16.1 years), no recurrence was identified. Eighteen of the enrolled patients had a history of cancer or concomitant cancer. Five patients died due to non-gastrointestinal-related causes. No additional cancer or death directly related to solitary PJP was observed. Conclusions Solitary PJPs did not recur in this study. Although examination of the entire gastrointestinal tract using esophagogastroduodenoscopy, enteroscopy, and colonoscopy is desirable to exclude Peutz-Jeghers syndrome, follow-up endoscopy after endoscopic polyp resection may be unnecessary, once the diagnosis of a solitary PJP is made.
Highlights
Peutz-Jeghers syndrome is an autosomal dominant genetic disorder characterized by the development of multiple polyps in the gastrointestinal tract in association with patches of hyperpigmentation in the mouth and on the hands and feet [1, 2]
Peutz-Jeghers syndrome was diagnosed when the patient had any of the following clinical criteria, and these patients were excluded from the study: 2 or more histologically confirmed Peutz-Jeghers polyp (PJP), any number of PJPs detected in a person whose family history included 1 close relative with Peutz-Jeghers syndrome, characteristic mucocutaneous pigmentation in a person whose family history included 1 close relative with Peutz-Jeghers syndrome, and any number of PJPs in a person who had characteristic mucocutaneous pigmentation [4,5,6]
The solitary PJP was found in the duodenum, jejunum, cecum, transverse colon, sigmoid colon, or rectum, while no cases of polyps in the esophagus, stomach, ileum, ascending colon, and descending colon were observed
Summary
Peutz-Jeghers syndrome is an autosomal dominant genetic disorder characterized by the development of multiple polyps in the gastrointestinal tract in association with patches of hyperpigmentation in the mouth and on the hands and feet [1, 2]. Are typically characterized by distinctive arborization of smooth muscle within the lamina propria [3] These hamartomatous lesions can present as solitary polyps in the gastrointestinal tract in patients without mucocutaneous pigmentation and are termed solitary Peutz-Jeghers polyps (PJPs). Clinical characteristics and prognosis of patients with a solitary Peutz-Jeghers polyp (PJP) have not been fully investigated. Solitary PJP was diagnosed when a single hamartomatous lesion was identified in the gastrointestinal tract of patients without mucocutaneous pigmentation or a family history of Peutz-Jeghers syndrome. Examination of the entire gastrointestinal tract using esophagogastroduodenoscopy, enteroscopy, and colonoscopy is desirable to exclude Peutz-Jeghers syndrome, follow-up endoscopy after endoscopic polyp resection may be unnecessary, once the diagnosis of a solitary PJP is made
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