What Is Cowden Syndrome?
Source: Genetic and Rare Diseases (GARD) Information Center
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Cowden Syndrome
Cowden disease; CD; Cowden's disease; CS; Multiple hamartoma syndrome; MHAM
Cowden syndrome is an inherited condition that is characterized primarily by multiple, noncancerous growths (called hamartomas) on various parts of the body.
Cowden-disease
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Cowden-disease2
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Source: Genetic and Rare Diseases (GARD) Information Center
Cowden-disease3
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Source: Genetic and Rare Diseases (GARD) Information Center
PTEN regulation image
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Source: Genetic and Rare Diseases (GARD) Information Center
Autosomal Dominant and Baby
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Source: Genetic and Rare Diseases (GARD) Information Center
Mapping Your Future: Screening for Disease Risk
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A diagnosis of Cowden syndrome is based on the presence of characteristic signs and symptoms. Genetic testing for a mutation in the PTEN gene can then be ordered to confirm the diagnosis. If a mutation in PTEN is not found, genetic testing for the other genes known to cause Cowden syndrome can be considered.
The National Comprehensive Cancer Network [NCCN 2015] consensus clinical diagnostic criteria have been divided into three categories:
A diagnosis is given if a patient has the "pathognomonic" skin lesions, two or more major criteria, one major and 3 or more minor criteria, or 4 or more minor criteria. The diagnostic criteria for adults and children have some differences.The PTEN Cleveland Clinic Risk Calculator can be used to estimate the chance of finding a PTEN mutation in children and adults with signs and symptoms of Cowden syndrome.
Finding mutations in the PTEN gene or other causal genes confirms diagnosis.
Source: Genetic and Rare Diseases (GARD) Information Center
Genetic Testing
Also called: DNA Testing, Mutation Screening, Genetic Test
Genetic testing is a type of test that analyze your cells or tissue to look for any changes in your DNA. Genetic tests may be used to identify increased risks of health problems, to choose treatments, or to assess responses to treatments.
PTEN Genetic Test
Also called: PTEN Gene Mutation Analysis, PTEN Testing, PTEN Mutation Testing, PTEN Sequencing and Deletion/Duplication
A PTEN genetic test looks for changes (mutations) in the PTEN gene. PTEN is a type of gene called a tumor suppressor. If you have a PTEN mutation (acquired or inherited), you are at higher risk for getting cancer.
Screening for Cancer
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Because Cowden syndrome is associated with an increased risk for certain types of cancer, management is typically focused on high-risk cancer screening. According to the National Comprehensive Cancer Network 2014, the recommended screening protocol for Cowden syndrome includes:
Cancer Screening for Women
Cancer Screening for Men and Women
**or individualized based on the earliest diagnosis of cancer in the family.
Pediatric (age <18 years)
If there are not any symptoms, observation alone is prudent. Cutaneous lesions should be removed only if malignancy is suspected or symptoms (e.g., pain, deformity, increased scarring) are serious. When symptomatic, topical agents (e.g., 5-fluorouracil), curettage, cryosurgery, or laser ablation may offer temporary relief. [Hildenbrand et al 2001].
Source: Genetic and Rare Diseases (GARD) Information Center
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