Marshall Maureen, Otero Doris, Niklander Sven, Martínez-Flores René
Unit of Oral Pathology and Oral Medicine, Faculty of Dentistry, Universidad Andres Bello, Calle Quillota 980, torre E, segundo piso, Viña del Mar, Chile.
Morphology Department, Faculty of Medicine, Universidad Andres Bello, Calle Quillota 980, torre D, sexto piso, Viña del Mar, Chile.
J Clin Exp Dent. 2021 Nov 1;13(11):e1162-e1166. doi: 10.4317/jced.58890. eCollection 2021 Nov.
Cowden's syndrome (CS), also known as multiple hamartoma syndrome, is a rare autosomal dominant genodermatosis first described in 1963. It has a high penetrance in both sexes and variable phenotypes. Its origin is a PTEN (phosphatase and tensin homologue) gene mutation and affects multiple organs of endodermal, ectodermal, and mesodermal origin, resulting in the development of hamartomatous mucocutaneus lesions and an increased risk for malignancies in breast, thyroid, endometrium, kidney, colon, rectum, among other organs. The diagnosis of CS is based mainly on clinical findings and oral cavity manifestations are frequent, occurring in 80-90% of patients. This include oral and labial papillomatous papules that usually precede the development of malignant tumours. Here, we report a case of a 58-years-old male with a presumptive diagnosis of multiple "pseudofibromas" in the oral cavity that was diagnosed with CS by a dental surgeon through the identification of extra and intraoral lesions, demonstrating the importance of awareness of this entity in the dental community to improve its early diagnosis, which is vital for the early detection and treatment of malignancies. Cowden's Syndrome, Multiple Hamartoma Syndrome, PTEN Hamartoma Tumor Syndrome, Papillomatous papules.
考登综合征(CS),又称多发性错构瘤综合征,是一种罕见的常染色体显性遗传性皮肤病,于1963年首次被描述。它在男女两性中都具有高外显率,且表型多样。其病因是PTEN(磷酸酶和张力蛋白同源物)基因突变,影响内胚层、外胚层和中胚层起源的多个器官,导致错构瘤性黏膜皮肤病变的发生,并增加乳腺、甲状腺、子宫内膜、肾脏、结肠、直肠等器官发生恶性肿瘤的风险。CS的诊断主要基于临床表现,口腔表现较为常见,80 - 90%的患者会出现。这包括口腔和唇部的乳头状丘疹,通常先于恶性肿瘤出现。在此,我们报告一例58岁男性病例,其口腔内有多个“假纤维瘤”的初步诊断,牙科医生通过识别口腔内外病变诊断为CS,这表明牙科领域认识该疾病对于改善早期诊断很重要,而早期诊断对于恶性肿瘤的早期发现和治疗至关重要。考登综合征、多发性错构瘤综合征、PTEN错构瘤肿瘤综合征、乳头状丘疹 。