Course and follow-up of solitary Peutz-Jeghers polyps: a case series

Abstract

Background and aims. Peutz-Jeghers syndrome (PJS) is a rare, autosomal-dominant disease characterized by hamartomatous polyps of the alimentary tract, hyperpigmentation of the skin, and family history of PJS. Rarely, solitary Peutz-Jeghers polyps (PJP) arise in patients without other features of PJS.

Patients and methods. We reviewed eight patients since 1979 with solitary PJP, six men and two women.

Results. The average age at diagnosis was higher (56±13 years) than that of PJS patients in the literature. Polyps were found in the sigmoid colon (n=4), cecum (n=1), stomach (n=1), and duodenum (n=2). The colonic polyps were diagnosed and removed endoscopically. Indications for colonoscopy included routine screening (n=4) or rectal bleeding (n=1). The duodenal and gastric polyps were diagnosed and removed during gastroduodenoscopic examinations, which were performed for nonspecific dyspepsia (n=2) or gastrointestinal bleeding (n=1). The median size was 20 mm (range 2 mm-25 mm). Patients were followed for a median of 11.5 years (range 3–22) without another PJP or cancer. Three patients died of causes unrelated to PJP. Five patients are alive and polyp free.

Conclusion. Solitary PJP do not carry a risk of gastrointestinal cancer and are not an indication for specific high-risk screening.