Identification of intestinal ganglioneuromatosis leads to early diagnosis of MEN2B: role of rectal biopsy

J Pediatr Surg. 2017 Jul;52(7):1161-1165. doi: 10.1016/j.jpedsurg.2016.10.054. Epub 2016 Nov 17.

Abstract

Background/purpose: Gastrointestinal symptoms are very common in patients with multiple endocrine neoplasia type 2B (MEN2B) syndrome. Herein, we present a case of intestinal ganglioneuromatosis (IGN) in MEN2B syndrome and a systematic literature review with a special focus on gastrointestinal symptoms prior to the diagnosis of MEN2B.

Methods: Literature search was performed (years 1966-2015) using the "Pubmed" and "Scopus" databases. Search terms used were gastrointestinal, intestinal and MEN2B.

Results: Literature search revealed 188 publications on MEN2B patients with gastrointestinal symptoms, providing a total of 55 patients including our own case. The far most common gastrointestinal symptom was constipation (72.7%). The onset of gastrointestinal symptoms occurred in 29 out of 55 cases (52.3%) below the age of 1year. However, MEN2B diagnosis was established at a median age of 13.0years (range 0-46years). The histological finding of IGN led to the diagnosis of MEN2B In 15 of 55 patients (27.3%) at a median age of 3years (range 0-31years).

Conclusion: Paying close attention to gastrointestinal problems in early childhood and taking a rectal biopsy that precisely screens for IGN offers the chance of diagnosing MEN2B syndrome early in infancy.

Keywords: Children; Diagnosis; Intestinal ganglioneuromatosis; MEN2B.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Biopsy
  • Child
  • Child, Preschool
  • Constipation
  • Early Detection of Cancer
  • Female
  • Ganglioneuroma / diagnosis*
  • Humans
  • Infant
  • Intestinal Neoplasms / diagnosis*
  • Male
  • Middle Aged
  • Multiple Endocrine Neoplasia Type 2b / diagnosis*
  • Young Adult