MUTYH-associated polyposis (MAP)

Question 1

MAP gene and inheritance pattern

Answer 1

MUTYH
autosomal recessive

Question 2

MAP clinical features

Answer 2

colon polyps (adenomas) and high risk of CRC (35-75%)
similar presentation as AFAP, but can be variable

Question 3

where do MAP CRCs present?

Answer 3

right-sided

Question 4

MAP management guidelines

Answer 4

• colonoscopy/polypectomy every 1-2y beginning at 25-30
• earlier depending on fam hx
• upper endoscopy beginning at 30-35
• total colectomy depending on overall polyp burden

Question 5

MAP extracolonic tumors

Answer 5

• gastric, small intestinal, endometrial, liver, ovarian, bladder, thyroid, skin, breast cancers
• benign lipomas, CHRPE, osteomas, desmoid tumors
• less frequent than in FAP, AFAP, or Lynch

Question 6

MUTYH heterozygotes

Answer 6

• modestly increased risk of CRC