Ponti Giovanni, Ponz de Leon Maurizio
Department of Internal Medicine, Division of Internal Medicine, University of Modena and Reggio Emilia, Via del Pozzo 71, 41100 Modena, Italy.
Lancet Oncol. 2005 Dec;6(12):980-7. doi: 10.1016/S1470-2045(05)70465-4.
Muir-Torre syndrome is an autosomal-dominant skin condition of genetic origin, characterised by tumours of the sebaceous gland or keratoacanthoma that are associated with visceral malignant diseases. The cutaneous characteristics of Muir-Torre syndrome are sebaceous adenoma, epithelioma, carcinoma, or multiple keratoacanthomas, whereas visceral malignant diseases include colorectal, endometrial, urological, and upper gastrointestinal tumours. Although Muir-Torre syndrome has a striking familial association and features of autosomal-dominant transmission, it can arise in individuals without a family history or any known mutations. Clinical and biomolecular evidence has suggested that there are two types of Muir-Torre syndrome. The most common is a variant of hereditary non-polyposis colorectal cancer, which is characterised by defects in mismatch repair genes and early-onset tumours. The second type does not show deficiency in mismatch repair and its pathogenesis remains undefined. Diagnosis of these rare sebaceous lesions warrants the search for associated internal malignant diseases: the peculiarity of skin lesions and their biomolecular characterisation with microsatellite instability analysis and immunohistochemistry could be used to identify familial Muir-Torre syndrome, allowing clinicians to tailor a personalised programme to screen for skin and visceral malignant diseases in high-risk individuals.
穆尔-托雷综合征是一种具有遗传起源的常染色体显性皮肤病,其特征为皮脂腺肿瘤或角化棘皮瘤,并伴有内脏恶性疾病。穆尔-托雷综合征的皮肤特征包括皮脂腺腺瘤、上皮瘤、癌或多发性角化棘皮瘤,而内脏恶性疾病包括结直肠癌、子宫内膜癌、泌尿系统肿瘤和上消化道肿瘤。尽管穆尔-托雷综合征有显著的家族关联和常染色体显性遗传特征,但它也可能出现在没有家族病史或任何已知突变的个体中。临床和生物分子证据表明,穆尔-托雷综合征有两种类型。最常见的是遗传性非息肉病性结直肠癌的一种变体,其特征为错配修复基因缺陷和早发性肿瘤。第二种类型没有错配修复缺陷,其发病机制尚不清楚。对这些罕见的皮脂腺病变进行诊断需要寻找相关的内部恶性疾病:皮肤病变的特殊性及其通过微卫星不稳定性分析和免疫组织化学进行的生物分子特征分析可用于识别家族性穆尔-托雷综合征,使临床医生能够制定个性化方案,对高危个体进行皮肤和内脏恶性疾病筛查。