On the afternoon of September 16, the Department of Gastrointestinal Endoscopy (A3D), 108 Central Military Hospital, said that the hospital had received a 37-year-old male patient who had multiple gastric polyps detected through endoscopy at a previous facility but had not yet been clearly diagnosed.

The patient was completely healthy, had a few soft tumors on the skin that grew over 10 years, but because they did not affect aesthetics and life, they were not treated.

After the incident of his father recently passing away from colon cancer, with the mentality of prevention is better than cure, the patient decided to go for a health check and accidentally discovered dense polyps in the stomach with sizes ranging from 0.2 - 1.4 cm, along with glycogen deposition lesions in the esophagus.

Because multiple gastric polyps are quite rare, doctors at the Department of Gastrointestinal Endoscopy performed resection of potentially dangerous polyps and biopsies to find the nature of these polyps. The pathological result was a hamartoma.

For soft tumors on the head, hands, shoulders and nodules on the back of the hands and face (photo below), patients are advised to have surgery to remove large soft tumors on the head and hands to both investigate the disease and to address the aesthetic problem. The results show that the masses are all sclerotic fibroma-like dermatofibroma.

The above clinical features and pathological lesions are completely consistent with Cowden syndrome (benign multiple tumor syndrome), a genetic disease characterized mainly by non-cancerous tumors (hamartomas) in many different parts of the body.

Doctor Nguyen Van Canh, Department of Gastrointestinal Endoscopy, 108 Central Military Hospital shared: Cowden syndrome is a rare genetic disorder with a worldwide incidence of 1/200,000 people. This syndrome occurs due to mutations in the PTEN genes (accounting for 25%), KLLN or WWP1.

Most patients with Cowden syndrome develop polyps in the upper gastrointestinal tract and colon and have a significantly increased risk of developing colorectal cancer.

Many abnormalities also appear on the patient's skin when the patient is over 20 years old such as: Papillomas, benign tumors originating from the outer layer of hair follicles, follicular keratosis, hemangiomas, vascular malformations, lipomas, papillomas on the tongue.

In addition, patients also have an increased risk of thyroid cancer and breast cancer.

For these patients, screening is needed to evaluate and remove high-risk polyps through endoscopy, to limit cancerous polyps or polyps that are too dense, requiring total removal of the stomach and colon.