Muir–Torre syndrome

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(Redirected from Torre syndrome)

Muir–Torre syndrome
Synonyms MTS
Pronounce
Field Oncology, Dermatology, Genetics
Symptoms Sebaceous tumors, internal malignancies
Complications Colorectal cancer, genitourinary cancers
Onset Usually adulthood
Duration Lifelong
Types
Causes Genetic mutations in MLH1, MSH2, MSH6 genes
Risks Family history of Lynch syndrome
Diagnosis Clinical presentation, genetic testing, immunohistochemistry
Differential diagnosis Sporadic sebaceous tumors, other hereditary cancer syndromes
Prevention Regular screening, genetic counseling
Treatment Surgical excision, regular cancer surveillance
Medication
Prognosis Good with early detection and management
Frequency Rare
Deaths Usually related to complications from malignancies


Muir–Torre syndrome (MTS) is a rare, hereditary autosomal dominant cancer syndrome, considered a subtype of Lynch syndrome (Hereditary Non-Polyposis Colorectal Cancer, HNPCC). Individuals with this syndrome have an increased susceptibility to cancers of the colon, genitourinary tract, and distinct skin lesions, including keratoacanthomas and sebaceous tumors such as sebaceous adenoma, sebaceous epithelioma, and sebaceous carcinoma.

Signs and Symptoms[edit | edit source]

Characteristic features include:

  • Presence of at least one sebaceous gland tumor (adenoma, epithelioma, or carcinoma)
  • Occurrence of at least one internal malignancy, commonly colorectal or genitourinary cancers

Genetics[edit | edit source]

Muir–Torre syndrome is caused primarily by mutations in the MLH1, MSH2, and more recently identified MSH6 genes. These genes are critical for the DNA mismatch repair pathway. Mutations result in defective DNA repair mechanisms, increasing the risk of developing cancers.

Diagnosis[edit | edit source]

Diagnosis typically involves:

  • Clinical evaluation of sebaceous skin tumors and internal malignancies
  • Genetic testing for mutations in DNA mismatch repair genes
  • Immunohistochemical analysis for mismatch repair proteins
  • Application of the Amsterdam criteria, widely used to diagnose Lynch syndrome and Muir–Torre syndrome, which include:
    • At least three relatives affected by Lynch-associated cancers (colorectal, endometrial, small bowel, ureter, renal pelvis)
    • Cancer affecting at least two successive generations
    • At least one individual diagnosed before age 50
    • Exclusion of familial adenomatous polyposis

The Mayo Muir–Torre risk score was developed to enhance diagnostic accuracy, distinguishing true cases from sporadic sebaceous tumors.

Management[edit | edit source]

Treatment strategies involve:

  • Surgical removal of skin lesions
  • Regular screening and surveillance for internal malignancies (colonoscopies, genitourinary screenings)
  • Genetic counseling for patients and their families

Prognosis[edit | edit source]

With appropriate management and regular surveillance, the prognosis for individuals with Muir–Torre syndrome can be favorable. Early detection and treatment of malignancies significantly improve outcomes.

Prevention[edit | edit source]

Preventive measures focus on:

  • Early genetic screening and counseling for at-risk families
  • Frequent surveillance for early detection of malignancies

Muir–Torre syndrome remains a rare condition, requiring multidisciplinary care involving dermatologists, geneticists, oncologists, and surgeons.

Eponym[edit | edit source]

It is named for EG Muir and D Torre. A British physician, Muir noted a patient with many keratoacanthomas who went on to develop several internal malignancies at a young age. Torre presented his findings at a meeting of the New York Dermatologic Society.

See also[edit | edit source]

External links[edit | edit source]



Classification
External resources



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