Effect of genetic profiling on surgical decisions at hereditary colorectal cancer syndromes.

Hereditary colorectal cancer syndromes, such as Lynch syndrome and familial adenomatous polyposis (FAP), present significant clinical challenges due to the heightened cancer risks associated with these genetic conditions. This review explores genetic profiling impact on surgical decisions for hereditary colorectal cancer (HCRC), assessing options, timing, and outcomes. Genotypes of different HCRCs are discussed, revealing a connection between genetic profiles, disease severity, and outcomes. For Lynch syndrome, mutations in the MLH1, MSH2, MSH6, and PMS2 genes guide the choice of surgery. Subtotal colectomy is recommended for patients with mutations in MLH1 and MSH2, while segmental colectomy is preferred for those with MSH6 and PMS2 mutations. In cases of metachronous colon cancer after segmental colectomy, subtotal colectomy with ileorectal anastomosis is advised for all mutations. Surgical strategies for primary rectal cancer include anterior resection or abdominoperineal resection (APR), irrespective of the specific mutation. For rectal cancer occurring after a previous segmental colectomy, proctocolectomy with ileal pouch-anal anastomosis (IPAA) or APR with a permanent ileostomy is recommended. In FAP, surgical decisions are based on genotype-phenotype correlations. The risk of desmoid tumors post-surgery supports a single-stage approach, particularly for certain APC gene variants. Juvenile Polyposis Syndrome (JPS) surgical decisions involve genetic testing, polyp characteristics with attention to vascular lesions in SMAD4 mutation carriers. However, genetic profiling does not directly dictate the specific surgical approach for JPS. In conclusion this review highlights the critical role of personalized surgical plans based on genetic profiles to optimize patient outcomes and reduce cancer risk. Further research is needed to refine these strategies and enhance clinical guidelines.

Parotid Masson's Tumor in a 29-years-old woman: A Case Report.

Introduction: Intravascular papillary endothelial hyperplasia (IPEH) is a papillary hyperplasia of the endothelial vascular cells, also called Masson's tumor. Masson's etiology and risk factors remain unclear but trauma and vascular pathologic conditions may start the tumor process from its common regions like extremities. Common presentations include swelling and mild pain. Our Radiologic modality of choice is Contrast-enhanced MRI which can help us before operating parotidectomy, the gold standard of tumor treatment. As presented in this study, Parotid Masson's tumor, is a very rare form of Masson's,making it even more exceptional. Case Report: This paper reports a case of a 29-years-old woman with a mass in herright parotid gland from 17 years ago, which has slowly increased in size during these years. She underwent a total parotidectomy following unsuccessful Fibrovein injections, which caused her inflammation. Embolization was performed before the resection to decrease the risk of its hemorrhage. Postoperative follow-up confirmed the reliability of this treatment method as the patient declared no side effects. Apart from its tough diagnosis, since Masson's tumors, especially the ones that emerge in the parotid, are rare, we decided to introduce this case to deliver more information about the treatment and diagnosis of this rare disease to other colleagues. Conclusions: The prognosis of parotid Masson's is admirable following a total resection. The patient had no postoperative complaints with no need for multiple visits after resection.