A 42-year-old female patient, with no personal history of interest, who came to the outpatient clinic of Oral and Maxillofacial Surgery of the Virgen de las Nieves University Hospital in Granada, presented with 15 lesions.
The intraoral examination of the patient also shows the presence of a tongue of appearance and authenticity.
Under local anesthesia and in two surgical times, complete excision of the lesions is performed.
The anatomopathological study of them typifies the lesions as fibropapillomas.
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Due to the characteristic stalked appearance of mucosal lesions, accompanied by the systemic examination of cutaneous trichilemomas in acral regions, the long time of evolution of these lesions, and the presence of a direct family history of papillary neoplasia proposed other
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In our hospital's emergency department, the patient is diagnosed with bilateral fibrocystic breast carcinoma and left-sided stage ductal carcinoma GII, which requires postoperative tumorectomy plus axillary chemotherapy homo collateral therapy and treatment.
The clinical diagnosis of genodermatosis of multiple hamartomas (the patient presents a pathognomonic lesion, a major criterion and three minor criteria), begins a complete process of systemic tumor screening.
The patient is evaluated in the Digestive Service, where the presence of asymptomatic thyroidism in the rectal mucosa and colonic mucosa is detected, after which she is referred to the Department of Endocrinology for progressive hyperthyroid evaluation.
After ruling out malignancy by cytohistological study, the patient is operated by the Endocrine Surgery Service performing total thyroidectomy.
The conclusive pathological result diagnosed the lesion as multinodular colloid goiter.
Five months after thyroid surgery, a mass in the right kidney was detected, which after studying with Computerized Tomography showed malignancy.
Associated to the Urology Department, it was decided to perform right radical nephrectomy plus supracaval lymphadenectomy.
The histological study of the surgical specimen diagnosed the lesion as renal carcinoma of clear and granular cells of fundamentally tubular component.
No postsurgical treatments are required.
At present the patient presents progressive decrease of visual acuity not affiliated in study by the Ophthalmology Service.
All neoplasic processes diagnosed and treated were detected in early stages.
At present the patient is in complete remission of all diagnosed and treated tumor pathology.
Despite having a clear clinical diagnosis almost from the beginning, the patient has been studied in the National Center of Oncological Research [Department of Human Genetics] confirming in a definitive way that the cGEN gene carrier is confirmed.
The study has been extended to other first-degree relatives to perform an appropriate screening and initiate close clinical follow-up if necessary.
