A 41-year-old man is diagnosed with iron deficiency anemia and is found to have heme-positive stools. Colonoscopy reveals a large ulcerated tumor in his transverse colon. He also has two smaller polyps in his ascending colon. Pathologic examination of the tumor biopsy reveals adenocarcinoma, while biopsies of the polyps confirm that these are adenomas. His sister has been diagnosed with uterine cancer, and two cousins have died of colon cancer. All of the following are true statements about this case except
A. Referral for genetic counseling is indicated
B. He is at increased risk for other epithelial-derived tumors
C. He likely has familial adenomatous polyposis (FAP), with a germ line mutation in the APC gene
D. His condition is often associated with a defect in DNA mismatch repair
Answer:C
A 41-year-old man is diagnosed with iron deficiency anemia and is found to have heme-positive stools. Colonoscopy reveals a large ulcerated tumor in his transverse colon. He also has two smaller polyps in his ascending colon. Pathologic examination of the tumor biopsy reveals adenocarcinoma, while biopsies of the polyps confirm that these are adenomas. His sister has been diagnosed with uterine cancer, and two cousins have died of colon cancer. All of the following are true statements about this case except
A. Referral for genetic counseling is indicated B. He is at increased risk for other epithelial-derived tumors C. He likely has familial adenomatous polyposis (FAP), with a germ line mutation in the APC gene D. His condition is often associated with a defect in DNA mismatch repair