Among the following, the least malignant potential for colorectal cancer is seen in polyps associated with?
ANSWER: (C) Peutz Jagher's SyndromeREF: APPENDIX-56 below for "HEREDITARY COLON CANCER SYNDROMES" APPENDIX - 56Hereditary Colon Cancer Syndromes(Ref: Sabistan Textbook of Surgery, 18th ed., Table 50-4) Hereditary Adenomatous Polyposis SyndromesHereditary Hamartomatous Polyposis SyndromesHereditary Nonpolyposis Colon Cancer (Lynch Syndrome)Familial Adenomatous Polyposis/Gardner's SyndromeTurcot'sSyndromeCowden's DiseaseFamilial Juvenile PolyposisPeutz-JeghersSyndromeSmall number of colorectal polypsHundreds to thousands of colorectal polyps; duodenal adenomas and gastric polypsColorectal polyps, which may be few or resemble classic FAPPolyps most commonly of colon and stomachJuvenile polyps (Defined by >10 polyps) throughout GIT, max Small number of polyps throughout GIT, max SIMuir-Torrevariant:sebaceousadenomas,sebaceousand basal cellepitheliomasOsteoma, desmoid tumours, epidermoid cysts, and congenital hypertrophy of retinal epitheliumBrain tumours (cerebellar medulloblastoma & glioblastoma)Mucocutaneous lesions, thyroid adenoma, goitre, fibroadenoma breast, uterine leiomyoma, & macrocephalyCongenital abnormalities (20%)- malrotation, hydrocephalus, CVS lesions, Meckel's diverticulumPigmented lesions of skin, benign 8r malignant genital tutors70%-80% lifetime risk for colorectal cancerColorectal cancer risk approaches 100%Colorectal carcinoma and brain tumours10% risk for thyroid cancer and up to 50% risk for adenocarcinoma of breast9% to 25% risk for colorectal cancer;| Risk for GI cancerColonoscopy at 20-25 yr.; repeat every 1-3 yr., Transvaginal USG or endometrial aspirate at age 20-25 yr.; repeat annuallyFlexible proctosigmoidoscopy at 10-12 yr.; repeat every 1-2 yr. until 35; after 35 repeat every 3 yr.Upper GI endoscopy every 1-3 yr. starting when polyps first identifiedSame as for FAP Also consider imaging of the brainAnnual physical exam with special attention to thyroid.Mammography at 30 yr. Routine colon cancer surveillanceScreening by 12 yr. (if no symptoms). Colonoscopy with multiple random biopsies every several yearsUpper GI endoscopy, small boivel radiography andcolonoscopy every 2 yr.;
Gardner's Syndrome
Turcot's Syndrome
Peutz Jagher's Syndrome
FAP
Colon and Rectum - Polyps and Carcinoma