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      Familial adenomatous polyposis in an adolescent with coexisting schizophrenia: treatment strategies and implications

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          Abstract

          Schizophrenia is associated with high mortality and morbidity. The etiology of schizophrenia remains unclear, studies implicate a multifactorial origin with genetic and environmental factors. The adenomatous polyposis coli (APC) gene has been associated with FAP (familial adenomatous polyposis), and studies have linked it to schizophrenia. However, there are few studies which examine the association between FAP and schizophrenia. Limited data exist regarding recommendations for genetic counseling of adolescents with comorbid psychiatric illness. A case of an adolescent with FAP who developed psychotic symptoms is presented. This case hopes to add to the literature about mental illness in those with FAP. A review of literature about the role of APC in schizophrenia as well as implications of genetic counseling on those who suffer with mental illness will be discussed.

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          Most cited references 14

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          Colorectal carcinoma in childhood and adolescence: a clinicopathologic review.

          Pediatric colorectal carcinoma (CRC) is rare, but the available data suggest that it is more likely than adult CRC to be advanced at presentation and to have a poor outcome. We sought to better characterize pediatric CRC. We reviewed the clinical and pathologic features, prognostic factors, and outcome of CRC in 77 children and adolescents (ages 7 to 19 years) referred to St Jude Children's Research Hospital between 1964 and 2003. At presentation, 76 patients had one or more signs or symptoms of CRC (abdominal pain, altered bowel habits, weight loss, anemia). Tumors were evenly distributed between the right and left colon; 62% were mucinous adenocarcinoma. At presentation, 86% of patients had advanced-stage disease; more than half had distant metastases. Overall outcome was poor. Advanced stage and mucinous histology were significant predictors of adverse outcome. Stage-specific survival at 10 years was 67% +/- 27% (stage 1), 38% +/- 15% (stage 2), 28% +/- 11% (stage III), and 7% +/- 4% (stage 4). Although no patient had a diagnosis of polyposis syndrome before diagnosis of CRC, 17 (22%) had colon polyps and eight (including two who previously underwent pelvic radiotherapy) had multiple polyps. Initial signs and symptoms of CRC are similar in pediatric and adult patients. The strikingly higher frequency of mucinous histology suggests that the biology of CRC differs in pediatric and adult patients and may contribute to poor outcomes. Children should be included in prospective clinical trials for CRC.
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            An international survey of predictive genetic testing in children for adult onset conditions

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              Colorectal carcinoma in children, adolescents, and young adults.

              The authors conducted a retrospective evaluation of patients younger than 30 years with colorectal carcinoma in Argentina. Patients were divided into group 1 (patients treated at pediatric institutions from 0 to 20 years of age, n = 14) and group 2 (patients from 21 to 30, n = 7, treated at adult centers). Group 1 had significantly more advanced disease and a poorer prognosis. Six patients (2/14 in group 1 and 4/7 in group 2) survive disease-free. Thirteen patients died of progressive disease, 1 died of a non-tumor-related cause, and 1 is still on treatment. Patients younger than 20 years have a poorer prognosis, probably because of advanced disease on presentation.
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                Author and article information

                Journal
                Mol Genet Genomic Med
                Mol Genet Genomic Med
                mgg3
                Molecular Genetics & Genomic Medicine
                John Wiley & Sons, Ltd (Chichester, UK )
                2324-9269
                2324-9269
                September 2015
                03 December 2014
                : 3
                : 5
                : 391-395
                Affiliations
                [1 ]Bronx Lebanon Hospital Center, Albert Einstein College of Medicine Bronx, New York
                [2 ]Albert Einstein College of Medicine Bronx, New York
                Author notes
                Correspondence Panagiota Korenis, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York. Tel: 718-590-1800; Fax: 718-901-8656; E-mail: korenismd@ 123456gmail.com

                Funding Information No funding information provided.

                Article
                10.1002/mgg3.114
                4585446
                © 2014 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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                Clinical Report

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