Peutz‐Jeghers syndrome with pseudoinvasion of hamartomatous polyps and multiple epithelial neoplasms

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Abstract
The risk of malignant change developing in the hamartomatous polyps in Peutz-Jeghers syndrome is widely held to be negligible. An association with tumors of the upper gastro-intestinal tract, ovary and other diverse multiple neoplasms is now recognized. Previously reported cases of malignant change in Peutz-Jeghers polyps may represent ''pseudoinvasion'' and such a case is reported. This was associated with carcinomas of the bile ducts, left tonsil and a papillary adenoma of the pancreatic duct. There may be a genetic predisposition to the development of neoplasms in this condition. Pathologists and clinicians must be aware of this entity of ''pseudoinvasion'' in order to avoid unnecessarily radical surgery in Peutz-Jeghers syndrome.