Case Report
Thyroid, Renal, and Breast Carcinomas, Chondrosarcoma, Colon
Adenomas, and Ganglioneuroma: A New Cancer Syndrome, FAP,
or Just Coincidence
Ihab Shafek Atta
1
and Fahd Nasser AlQahtani
2
1
Department of Pathology, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut 71524, Egypt
2
Department of Radiology, Faculty of Medicine, Al-Baha University, Saudi Arabia
Correspondence should be addressed to Ihab Shafek Atta; attaihab@yahoo.com
Received 30 November 2015; Revised 8 February 2016; Accepted 18 February 2016
Academic Editor: Mark E. Shafrey
Copyright © 2016 I. S. Atta and F. N. AlQahtani. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
We are presenting a case associated with papillary thyroid carcinoma, renal cell carcinoma, invasive mammary carcinoma,
chondrosarcoma, benign ganglioneuroma, and numerous colon adenomas. Te patient had a family history of colon cancer,
kidney and bladder cancers, lung cancer, thyroid cancer, leukemia, and throat and mouth cancers. She was diagnosed with
colonic villous adenoma at the age of 41 followed by thyroid, renal, and breast cancers and chondrosarcoma at the ages of
48, 64, 71, and 74, respectively. Additionally, we included a table with the most common familial cancer syndromes with
one or more benign or malignant tumors diagnosed in our case, namely, FAP, HNPCC, Cowden, Peutz-Jeghers, renal cancer,
tuberous sclerosis, VHL, breast/other, breast/ovarian, Carney, Werner’s, Bloom, Li-Fraumeni, xeroderma pigmentosum, ataxia-
telangiectasia, osteochondromatosis, retinoblastoma, and MEN2A.
1. Introduction
A cancer diagnosed at young age, multifocal or bilateral in
paired organs, more than one primary unrelated cancer, fam-
ily history of cancer, or congenital anomalies will make the
diagnosis of family cancers syndromes a high possibility [1].
Familial adenomatous polyposis (FAP) is a syndrome with
mutations in APC gene on 5q21–q22. Diagnosis of FAP is
suspected clinically in the presence of hundreds of colorectal
polyps running in certain families but mutational analysis
study is the golden test for diagnosis. Colon cancer, follicular
cancer, papillary thyroid cancer, gastric cancer, and medul-
loblastomas (Turcot syndrome) are the most common malig-
nant tumors [2, 3]. Associated benign lesions are colonic,
gastric, and duodenal polyps [4, 5]. Hereditary Nonpolyposis
Colon Cancer (HNPCC) is another syndrome with reported
mutations in the mismatch repair gene (MMR) complexes
that include several mutations as hMLH1 at 3p21.3, hMSH2 at
2p22–p21, hPMS1 at 2q31–q33, hPMS2 at 7p22, and hMSH6 at
2p16 [6]. Diagnosis depends on a family pedigree with colon
cancer diagnosed before the age of 50 with no familial ade-
nomatous polyposis detected [6]. Associated malignant neo-
plasms are colorectal, endometrial, ovarian, and transitional
cell cancers of the urinary system, gastric cancer, small bowel
cancer, pancreas cancer, hepatobiliary carcinoma, sebaceous
carcinoma, glioblastoma multiforme, and breast cancer [2,
7]. Associated benign neoplasms are colonic adenomas,
keratoacanthomas, sebaceous adenomas, and epitheliomas.
Cowden syndrome is reported with mutations in PTEN gene
at 10q23 [8–10]. Clinical diagnosis is based on mucocuta-
neous lesions, intestinal hamartomas, craniomegaly, coarse,
dark hair, rapid overgrowth of breasts, and cerebellar glial
mass leading to altered gait and seizures (Lhermitte-Duclos
disease). Associated malignant tumors are breast, thyroid,
colon, kidney, ovary, endometrium, and lung carcinomas,
melanoma, Merkel cell skin cancer, and retinal glioma. Asso-
ciated benign lesions are skin verruci of the face and limbs,
hyperkeratotic papules of the gingiva and buccal mucosa,
facial trichilemmomas, oral mucosal fbromas, hyperkerato-
sis of hand and foot, hamartomatous polyps of stomach, small
Hindawi Publishing Corporation
Case Reports in Medicine
Volume 2016, Article ID 2928084, 5 pages
http://dx.doi.org/10.1155/2016/2928084