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Sessile serrated polyposis cancer syndrome(SSPCS)

MedGen UID:
934681
Concept ID:
C4310714
Neoplastic Process
Synonym: SSPCS
 
Gene (location): RNF43 (17q22)
 
Monarch Initiative: MONDO:0014919
OMIM®: 617108

Definition

Sessile serrated polyposis cancer syndrome (SSPCS) is a rare disorder characterized by the presence of multiple serrated polyps in the colon and an increased personal and familial risk of colorectal cancer. SSPCS is defined by the World Health Organization (WHO) as the presence of at least 5 sessile serrated polyps (also known as 'sessile serrated adenomas,' or SSAs) proximal to the sigmoid colon, with 2 or more that are greater than 10 mm in diameter; or any number of serrated polyps in a person with a first-degree relative with SSPCS; or more than 20 serrated polyps of any size, distributed throughout the colon. SSAs are found in 2% of average-risk individuals undergoing their first screening colonoscopy, and are estimated to be responsible for 20 to 35% of all colon cancers. SSAs exhibit somatic mutations in the BRAF gene (164757), or less commonly in the KRAS gene (190070), early in their development. Individuals with SSPCS have a lifetime risk of colon cancer as high as 54% and may have a strong personal or family history of extracolonic cancers; first-degree relatives have a 32% risk of developing multiple serrated polyps and a 5-fold increased risk of colon cancer. An increased risk of pancreatic cancer has also been observed (summary by Gala et al., 2014). [from OMIM]

Clinical features

From HPO
Serrated intestinal polyps
MedGen UID:
1693793
Concept ID:
C5139207
Disease or Syndrome
The presence of multiple serrated polyps in the intestine. Unlike conventional adenomas, which are uniformly dysplastic, the vast majority of serrated lesions contain no dysplasia. The serrated class includes the hyperplastic polyps, which are not considered precancerous; sessile serrated polyps (also called sessile serrated adenomas); and traditional serrated adenomas. Sessile serrated polyps are larger on average and more often located in the proximal colon. Sessile serrated polyps have a more irregular surface, a pattern to the surface that has been called cloudlike, and indistinct edges compared with hyperplastic polyps. Sessile serrated polyps also have large open pits on the surface (type O pits) when viewed with magnification.

Professional guidelines

PubMed

East JE, Atkin WS, Bateman AC, Clark SK, Dolwani S, Ket SN, Leedham SJ, Phull PS, Rutter MD, Shepherd NA, Tomlinson I, Rees CJ
Gut 2017 Jul;66(7):1181-1196. Epub 2017 Apr 27 doi: 10.1136/gutjnl-2017-314005. PMID: 28450390Free PMC Article
Rivero-Sanchez L, Lopez-Ceron M, Carballal S, Moreira L, Bessa X, Serradesanferm A, Pozo A, Augé JM, Ocaña T, Sánchez A, Leoz ML, Cuatrecasas M, Grau J, Llach J, Castells A, Balaguer F, Pellisé M; Procolon Group
Endoscopy 2017 Jan;49(1):44-53. Epub 2016 Oct 14 doi: 10.1055/s-0042-115640. PMID: 27741536
Rosty C, Hewett DG, Brown IS, Leggett BA, Whitehall VL
J Gastroenterol 2013 Mar;48(3):287-302. Epub 2012 Dec 4 doi: 10.1007/s00535-012-0720-y. PMID: 23208018Free PMC Article

Curated

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Rectal Cancer, 2024

Suggested Reading

Recent clinical studies

Etiology

Mangira D, Raftopoulos S, Vogrin S, Hartley I, Mack A, Gazelakis K, Nalankilli K, Trinh A, Metz AJ, Appleyard M, Grimpen F, Elliott T, Brown G, Moss A
Endoscopy 2023 Jul;55(7):627-635. Epub 2023 Feb 7 doi: 10.1055/a-2029-9539. PMID: 36750222
Mansilla-Vivar R, Petruzzellis C, Olivari N, Milluzzo SM, Grassano A, Cesari P, Zorzi F, Spada C
Rev Gastroenterol Peru 2021 Oct-Dec;41(4):245-253. PMID: 35613395
Cauley CE, Hassab TH, Feinberg A, Church J
Dis Colon Rectum 2020 Feb;63(2):183-189. doi: 10.1097/DCR.0000000000001537. PMID: 31914111
Gupta V, East JE
Gut Liver 2020 Jul 15;14(4):423-429. doi: 10.5009/gnl19202. PMID: 31581390Free PMC Article
Langner C
Dig Dis 2015;33(1):28-37. Epub 2014 Dec 17 doi: 10.1159/000366032. PMID: 25531494

Diagnosis

Dierick NR, Nicholson BD, Fanshawe TR, Sundaralingam P, Kostalas SN
BMC Gastroenterol 2024 May 16;24(1):167. doi: 10.1186/s12876-024-03247-2. PMID: 38755550Free PMC Article
Muller C, Yamada A, Ikegami S, Haider H, Komaki Y, Komaki F, Micic D, Sakuraba A
Clin Gastroenterol Hepatol 2022 Mar;20(3):622-630.e7. Epub 2021 Jun 2 doi: 10.1016/j.cgh.2021.05.057. PMID: 34089849
Mansilla-Vivar R, Petruzzellis C, Olivari N, Milluzzo SM, Grassano A, Cesari P, Zorzi F, Spada C
Rev Gastroenterol Peru 2021 Oct-Dec;41(4):245-253. PMID: 35613395
Hyun E, Helewa RM, Singh H, Wightman HR, Park J
Can J Surg 2021 Nov-Dec;64(6):E561-E566. Epub 2021 Nov 2 doi: 10.1503/cjs.018820. PMID: 34728521Free PMC Article
van Herwaarden YJ, Koggel LM, Simmer F, Vink-Börger EM, Dura P, Meijer GA, Nagengast FM, Hoogerbrugge N, Bisseling TM, Nagtegaal ID
Histopathology 2021 Apr;78(5):749-758. Epub 2020 Dec 25 doi: 10.1111/his.14286. PMID: 33098683Free PMC Article

Therapy

Mangira D, Raftopoulos S, Vogrin S, Hartley I, Mack A, Gazelakis K, Nalankilli K, Trinh A, Metz AJ, Appleyard M, Grimpen F, Elliott T, Brown G, Moss A
Endoscopy 2023 Jul;55(7):627-635. Epub 2023 Feb 7 doi: 10.1055/a-2029-9539. PMID: 36750222
Muller C, Yamada A, Ikegami S, Haider H, Komaki Y, Komaki F, Micic D, Sakuraba A
Clin Gastroenterol Hepatol 2022 Mar;20(3):622-630.e7. Epub 2021 Jun 2 doi: 10.1016/j.cgh.2021.05.057. PMID: 34089849
Cauley CE, Hassab TH, Feinberg A, Church J
Dis Colon Rectum 2020 Feb;63(2):183-189. doi: 10.1097/DCR.0000000000001537. PMID: 31914111
López-Vicente J, Rodríguez-Alcalde D, Hernández L, Riu Pons F, Vega P, Herrero Rivas JM, Santiago García J, Salces Franco I, Bustamante Balén M, López-Cerón M, Pellisé M; Endoscopy for High Risk Cancer Conditions group of the Spanish Gastroenterological Association and Spanish Digestive Endoscopy Society
Clin Gastroenterol Hepatol 2019 Sep;17(10):2016-2023.e6. Epub 2018 Oct 24 doi: 10.1016/j.cgh.2018.10.029. PMID: 30366156
East JE, Atkin WS, Bateman AC, Clark SK, Dolwani S, Ket SN, Leedham SJ, Phull PS, Rutter MD, Shepherd NA, Tomlinson I, Rees CJ
Gut 2017 Jul;66(7):1181-1196. Epub 2017 Apr 27 doi: 10.1136/gutjnl-2017-314005. PMID: 28450390Free PMC Article

Prognosis

Dierick NR, Nicholson BD, Fanshawe TR, Sundaralingam P, Kostalas SN
BMC Gastroenterol 2024 May 16;24(1):167. doi: 10.1186/s12876-024-03247-2. PMID: 38755550Free PMC Article
Kanth P, Yu Z, Keener MB, Koptiuch C, Kohlmann WK, Neklason DW, Westover M, Curtin K
Am J Gastroenterol 2022 Feb 1;117(2):336-342. doi: 10.14309/ajg.0000000000001572. PMID: 34889311
Muller C, Yamada A, Ikegami S, Haider H, Komaki Y, Komaki F, Micic D, Sakuraba A
Clin Gastroenterol Hepatol 2022 Mar;20(3):622-630.e7. Epub 2021 Jun 2 doi: 10.1016/j.cgh.2021.05.057. PMID: 34089849
Bozorg SR, Song M, Emilsson L, Ludvigsson JF
BMC Gastroenterol 2019 Dec 31;20(1):3. doi: 10.1186/s12876-019-1134-6. PMID: 31892305Free PMC Article
Carballal S, Rodríguez-Alcalde D, Moreira L, Hernández L, Rodríguez L, Rodríguez-Moranta F, Gonzalo V, Bujanda L, Bessa X, Poves C, Cubiella J, Castro I, González M, Moya E, Oquiñena S, Clofent J, Quintero E, Esteban P, Piñol V, Fernández FJ, Jover R, Cid L, López-Cerón M, Cuatrecasas M, López-Vicente J, Leoz ML, Rivero-Sánchez L, Castells A, Pellisé M, Balaguer F; Gastrointestinal Oncology Group of the Spanish Gastroenterological Association
Gut 2016 Nov;65(11):1829-1837. Epub 2015 Aug 11 doi: 10.1136/gutjnl-2015-309647. PMID: 26264224

Clinical prediction guides

Dierick NR, Nicholson BD, Fanshawe TR, Sundaralingam P, Kostalas SN
BMC Gastroenterol 2024 May 16;24(1):167. doi: 10.1186/s12876-024-03247-2. PMID: 38755550Free PMC Article
Mangira D, Raftopoulos S, Vogrin S, Hartley I, Mack A, Gazelakis K, Nalankilli K, Trinh A, Metz AJ, Appleyard M, Grimpen F, Elliott T, Brown G, Moss A
Endoscopy 2023 Jul;55(7):627-635. Epub 2023 Feb 7 doi: 10.1055/a-2029-9539. PMID: 36750222
Nakamura F, Sato Y, Okamoto K, Fujino Y, Mitsui Y, Kagemoto K, Kawaguchi T, Miyamoto H, Muguruma N, Sonoda T, Tsuneyama K, Takayama T
J Gastroenterol 2022 Apr;57(4):286-299. Epub 2022 Feb 23 doi: 10.1007/s00535-022-01858-8. PMID: 35194694
Kanth P, Yu Z, Keener MB, Koptiuch C, Kohlmann WK, Neklason DW, Westover M, Curtin K
Am J Gastroenterol 2022 Feb 1;117(2):336-342. doi: 10.14309/ajg.0000000000001572. PMID: 34889311
Carballal S, Rodríguez-Alcalde D, Moreira L, Hernández L, Rodríguez L, Rodríguez-Moranta F, Gonzalo V, Bujanda L, Bessa X, Poves C, Cubiella J, Castro I, González M, Moya E, Oquiñena S, Clofent J, Quintero E, Esteban P, Piñol V, Fernández FJ, Jover R, Cid L, López-Cerón M, Cuatrecasas M, López-Vicente J, Leoz ML, Rivero-Sánchez L, Castells A, Pellisé M, Balaguer F; Gastrointestinal Oncology Group of the Spanish Gastroenterological Association
Gut 2016 Nov;65(11):1829-1837. Epub 2015 Aug 11 doi: 10.1136/gutjnl-2015-309647. PMID: 26264224

Recent systematic reviews

Muller C, Yamada A, Ikegami S, Haider H, Komaki Y, Komaki F, Micic D, Sakuraba A
Clin Gastroenterol Hepatol 2022 Mar;20(3):622-630.e7. Epub 2021 Jun 2 doi: 10.1016/j.cgh.2021.05.057. PMID: 34089849

Supplemental Content

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    Curated

    • NCCN, 2024
      NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Rectal Cancer, 2024

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