Synonyms

• PHTS

Disorder Subdivisions

• Bannayan-Riley-Ruvalcaba Syndrome
• Cowden Disease
• Cowden Syndrome
• Multiple Hamartoma Syndrome
• Proteus Syndrome
• Proteus-like Syndrome

General Discussion

The PTEN hamartoma tumor syndrome (PHTS) is a spectrum of disorders caused by mutations of the PTEN gene. These disorders are characterized by multiple hamartomas that can affect various areas of the body. Hamartoma is a general term for benign tumor-like malformations that can affect any area of the body. Hamartomas are composed of mature cells and tissue normally found in the affected area.



PHTS includes virtually all cases of Cowden syndrome (also known as multiple hamartoma syndrome) and a percentage of cases of Bannayan-Riley-Ruvalcaba syndrome, Proteus syndrome and Proteus-like syndrome (i.e., those associated with mutations of the PTEN gene). For more information on Bannayan-Riley-Ruvalcaba syndrome and Proteus syndrome, see NORD's individual reports on these disorders in the Rare Disease Database.



Cowden syndrome is a difficult to recognize, under-diagnosed genetic disorder characterized by the development of multiple, benign tumor-like malformations (hamartomas) in various areas of the body. Affected individuals also have a predisposition to developing certain cancers, especially cancer of the breast, thyroid or mucous membrane lining the uterus (endometrium). The specific symptoms of Cowden syndrome vary from case to case.



Bannayan-Riley-Ruvalcaba syndrome is characterized by an abnormally large head (macrocephaly), the development of multiple benign growths (hamartomatous polyps) in the intestines (intestinal polyposis), benign tumors just below the skin consisting of fatty tissue (lipomas), and excessive growth before and after birth. Symptoms vary from case to case.



Proteus syndrome is a rare, complex growth disorder characterized by disproportionate overgrowth of various parts of the body. Tissue of the bone, skin, central nervous system and eye and connective tissue are most often affected. The specific symptoms vary greatly from case to case.



The term Proteus-like syndrome is used to describe individuals with significant features of Proteus syndrome, but who fail to meet the specific diagnostic criteria for the disorder, for Cowden syndrome and for Bannayan-Riley-Ruvalcaba syndrome. Germline PTEN mutations have been identified in approximately 50 percent of these cases.

PHTS is inherited as an autosomal dominant trait. The symptoms vary greatly from case to case even among individuals in the same family. In fact, some families have members with Cowden syndrome and others with Bannayan-Riley-Ruvalcaba syndrome. In some cases, the symptoms of the two disorders may occur in the same individual, which is referred to as the Cowden/Bannayan-Riley-Ruvalcaba overlap syndrome. The likelihood of finding a germline PTEN mutation in overlap families is very high (>95%).

Resources

March of Dimes Birth Defects Foundation

1275 Mamaroneck Avenue

White Plains, NY 10605

Tel: (914)997-4488

Fax: (914)997-4763

Tel: (888)663-4637

Email: Askus@marchofdimes.com

Internet: http://www.marchofdimes.com



American Cancer Society, Inc.

1599 Clifton Road NE

Atlanta, GA 30329

USA

Tel: (404)320-3333

Tel: (800)227-2345

TDD: (866)228-4327

Internet: http://www.cancer.org



National Cancer Institute

6116 Executive Blvd

MSC 8322

Room 3036A

Bethesda, MD 20892-8322

USA

Tel: (301)435-3848

Tel: (800)422-6237

TDD: (800)332-8615

Email: cancergovstaff@mail.nih.gov

Internet: http://www.cancer.gov



Rare Cancer Alliance

1649 North Pacana Way

Green Valley, AZ 85614

USA

Tel: (520)625-5495

Fax: (615)526-4921

Internet: http://www.rare-cancer.org



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



Madisons Foundation

PO Box 241956

Los Angeles, CA 90024

Tel: (310)264-0826

Fax: (310)264-4766

Email: getinfo@madisonsfoundation.org

Internet: http://www.madisonsfoundation.org

For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders (NORD). A copy of the complete report can be downloaded free from the NORD website for registered users. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational therapies (if available), and references from medical literature. For a full-text version of this topic, go to MyD-H, the Dartmouth-Hitchcock patient portal. You must be a registered MyD-H user for the Lebanon, Manchester, or Nashua locations to access this site.

The information provided in this report is not intended for diagnostic purposes. It is provided for informational purposes only. NORD recommends that affected individuals seek the advice or counsel of their own personal physicians.

It is possible that the title of this topic is not the name you selected. Please check the Synonyms listing to find the alternate name(s) and Disorder Subdivision(s) covered by this report

This disease entry is based upon medical information available through the date at the end of the topic. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder.

For additional information and assistance about rare disorders, please contact the National Organization for Rare Disorders at P.O. Box 1968, Danbury, CT 06813-1968; phone (203) 744-0100; web site www.rarediseases.org or email orphan@rarediseases.org

Last Updated:  4/30/2007

Copyright  2007 National Organization for Rare Disorders, Inc.