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

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.