[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-406114-105":59,"doc-detail-406114-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","looking-beyond-the-surface-muir-torre-syndrome","Looking beyond the surface - Muir Torre syndrome","","Muir-Torre Syndrome (MTS) is associated with multiple visceral malignancies and may initially appear as a benign-appearing skin tumor resembling a sebaceous cyst. This case report describes a 67-year-old man whose excised sebaceoma led to suspected MTS, yet he declined screening colonoscopy and genetic testing. Later, iron deficiency anemia revealed advanced colon cancer, ultimately progressing to palliation after surgery.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/looking-beyond-the-surface-muir-torre-syndrome/406114/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/looking-beyond-the-surface-muir-torre-syndrome/406114.png","ImageObject",300,407,{"name":92,"@type":93},"Cart","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How did the skin lesion lead to suspicion of Muir-Torre syndrome?","Question",{"text":112,"@type":113},"The excised lesion was diagnosed as a sebaceoma. Histology plus immunochemistry showed loss of MSH2 and MSH6, which supported an allelic variant consistent with Lynch syndrome and raised suspicion for MTS.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What actions were declined after MTS was suspected?",{"text":117,"@type":113},"Genetic counselling was requested, but the patient was not recommended surveillance colonoscopy or further genetic investigations due to a lack of reported family history of colorectal cancer.",{"name":119,"@type":110,"acceptedAnswer":120},"What ultimately revealed the presence of advanced disease?",{"text":121,"@type":113},"In December 2020, iron deficiency anemia prompted gastroscopy and colonoscopy, identifying a hepatic flexure adenocarcinoma. Subsequent staging showed no metastasis initially, but later surveillance detected lung, liver, and bony metastases.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},406114,1790740621,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},18829141979164,"https://eur-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","CASE REPORT  \nLooking beyond the surface: Muir Torre syndrome  \nEkta Bagga1, David Innes2, Edmund Leung 1,n  \n1 Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 2 Taranaki Pathology Services, New Plymouth, Taranaki, New Zealand.  \nnCorrespondence: Edmund Leung, Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton,  \nAuckland 1010, New Zealand. Email: [ed.leung@doctors.org.uk](ed.leung@doctors.org.uk)  \nHow to cite this article: Bagga E, Innes D, Leung E. Looking beyond the surface: Muir Torre syndrome. Arch Clin Cases. 2023;10(3):119-122 . doi: 10.22551/ 2023.40.1003.10255  \nABSTRACT  \nMuir-Torre Syndrome (MTS) is associated with multiple visceral malignancies. Initial presentation may be a benign skin tumor mimicking a sebaceous cyst. This case report highlights the importance of early diagnosis, genetic testing, and multidisciplinary screening. A 67-year-old man was diagnosed with MTS following excision of a skin lesion (sebaceoma) . He was declined both screening colonoscopy and genetic testing. Subsequently, advanced colon cancer was found following presentation with iron deficiency anemia, which ultimately led to palliation despite successful surgery. MTS can present insidiously with skin lesions clinically diagnosed as sebaceous cysts. Once MTS is suspected on histology, genetic testing and screening for MTS-related cancers is warranted. Better understanding of the genetic variants for MTS can aid in earlier diagnosis thus not dismissing the need for screening for MTS-related cancers.  \nKEYWORDS: Muir-Torre Syndrome; Lynch Syndrome; Colorectal Cancer; Sebaceoma  \n’ INTRODUCTION  \nSebaceomas can be sporadic or associated with MTS. Upon histological diagnosis, nuclear staining for MSH2 and MSH6 is required to assess microsatellite instability. MTS is considered a phenotypic variant of hereditary nonpolyposis colorectal carcinoma syndrome (HNPCC or Lynch syndrome) and is caused by germline mutations in one allele of the DNA mismatch repair (MMR) genes [7] . We discuss the essence of vigilance by a pathologist with a case and subsequent diagnosis of colon cancer.  \n’ CASE PRESENTATION  \nA 67-year-old Caucasian man presented to his general practitioner in June 2020 with a long-standing skin lesion on his right upper back (Figure 1) . He had a history of melanoma and prostate cancer years prior. The patient was referred in for removal as it has been bothering him. Both his GP and skin specialist documented that the lesion was clinically a sebaceous cyst. The lesion was excised in October 2020, within a timeframe of a routine referral, and sent for histology.  \nHistology came back conclusive of a sebaceoma: smaller lobules of basaloid cells admixed with cells showing sebaceous differentiation. Immunochemistry for Mismatch Repair (MMR) proteins showed a loss of MSH2 and MSH6, consistent of an allelic variant of Lynch Syndrome (Figure 2) . In the context of a sebaceoma, MTS was suspected.  \nReceived: June 2023; Accepted after review: August 2023;  \nPublished: September 2023 .  \nThe patient was referred for genetic counselling. However, given lack of family history of colorectal cancer, he was not recommended surveillance colonoscopy or further genetic investigations.  \nIn December 2020, the patient presented with iron deficiency anemia: ferritin and hemoglobin was 5ng/mLand 115g/L respectively. He was referred in for a gastroscopy and colonoscopy. A hepatic flexure adenocarcinoma was identified (Figure 3) . Subsequent staging computed tomography (CT) scan showed no metastasis.  \nThe patient was an alcoholic on Methotrexate and steroids for rheumatoid arthritis. He took Dabigatran, atorvastatin and Metoprolol for recurrent deep vein thrombosis, atrial fibrillation, and ischemic heart & cerebral disease.  \nThe patient underwent laparoscopic complete mesocolic right hemicolectomy with an ileostomy. His risk of ananas","cbCaisQ7AsvtwMrV","https://ap.wps.com/l/cbCaisQ7AsvtwMrV","pdf",932117,"English","# Abstract\n# Introduction\n# Case Presentation\n# Discussion","[{\"question\":\"How did the skin lesion lead to suspicion of Muir-Torre syndrome?\",\"answer\":\"The excised lesion was diagnosed as a sebaceoma. Histology plus immunochemistry showed loss of MSH2 and MSH6, which supported an allelic variant consistent with Lynch syndrome and raised suspicion for MTS.\"},{\"question\":\"What actions were declined after MTS was suspected?\",\"answer\":\"Genetic counselling was requested, but the patient was not recommended surveillance colonoscopy or further genetic investigations due to a lack of reported family history of colorectal cancer.\"},{\"question\":\"What ultimately revealed the presence of advanced disease?\",\"answer\":\"In December 2020, iron deficiency anemia prompted gastroscopy and colonoscopy, identifying a hepatic flexure adenocarcinoma. Subsequent staging showed no metastasis initially, but later surveillance detected lung, liver, and bony metastases.\"}]","Looking beyond the surface - Muir Torre syndrome | PDF",1790563605]