Peutz-Jeghers syndrome: Diagnostic and therapeutic approach

Table 1 Benefits and drawbacks of endoscopic methods[39,77]

Method	Intra-operative enteroscopy	Double balloon enteroscopy
Benefits	All polyps removed in one procedure	Less invasive
	Partnership with a surgeon	Well tolerated
	Less time-consuming for endoscopist	Shorter sick leave
Drawbacks	Necessity of laparotomy	Often more than one procedure required
	Possibility of adhesions formation	Not feasible in some patients (because of adhesions)
	Longer convalescence	Longer procedure

Table 2 Cancer screening in PJS patients[13-17,22]

Site of possible tumour	Age of screening initiation	Periodicity	Method of screening
Colon	15 yr1	2 yr2	Colonoscopy, CA 19-9
Oral parts of GIT	15 yr1	2 yr2	Gastroscopy
Small intestine	15 yr1	2 yr2	Capsule enteroscopy or MRI scan
Breast	21 yr	Monthly	Self-examination
		6-12 mo	Sonography or mammography, CA 125
Thyroid gland	18 yr	1 yr	Sonography, clinical examination
Pancreas	18 yr	1 yr	Sonography or CT or MRI scan
Uterus and ovaria	18 yr	1 yr	Sonography, clinical examination
Testes	18 yr	1 yr	Sonography, clinical examination
Lung	18 yr	5 yr?	X-ray, clinical examination

¹Earlier in symptomatic persons;

²Endoscopy each year as long as polyps are present, subsequently prolong intervals. PJS: Peutz-Jeghers syndrome.