Muir‐Torre syndrome appropriate use criteria: Effect of patient age on appropriate use scores. (26th April 2019)

• Record Type: Journal Article
• Authors: Vidal, Claudia I.; Sutton, Angela; Armbrect, Eric A.; Lee, Jason B.; Litzner, Brandon R.; Hurley, M. Yadira; Alam, Murad; Duncan, Lyn M.; Elston, Dirk M.; Emanuel, Patrick O.; Ferringer, Tammie; Fung, Maxwell A.; Hosler, Gregory A.; Lazar, Alexander J.; Lowe, Lori; Plaza, Jose A.; Robinson, June K.; Schaffer, Andras
• Is Part Of: Journal of cutaneous pathology. Volume 46:Number 7(2019)
• Page Start: 484
• Page End: 489
• Publication Date: 2019-04-26
• Subjects: anatomic location -- appropriate use criteria -- expert rating -- immunohistochemistry -- mismatch repair protein analysis -- Muir‐Torre syndrome -- patient age -- sebaceous neoplasms; Skin -- Diseases -- Periodicals; Dermatology -- Periodicals; 616
• DOI: 10.1111/cup.13459
• Languages: English
• ISSNs: 0303-6987

Abstract

Abstract : Background: Muir‐Torre syndrome (MTS) is a rare inherited syndrome, with an increased risk of sebaceous and visceral malignancy. Prior reports suggest screening for mismatch repair (MMR) deficiency may be warranted in patients <50 years and when sebaceous neoplasms are located on a non‐head and neck location. Previously, appropriate use criteria (AUC) were developed for clinical scenarios in patients >60 years concerning the use of MMR protein immunohistochemistry (MMRP‐IHC). This analysis explores the appropriateness of testing in patients ≤60 years. Methods: Panel raters from the AUC Task Force rated the use of MMRP‐IHC testing for MTS for previously rated scenarios with the only difference being age. Results: Results verify the previously developed AUC for the use of MMRP‐IHC in neoplasms associated with MTS in patients >60 years. Results also show that in patients ≤60 years with a single sebaceous tumor on a non‐head and neck site, MMRP‐IHC testing should be considered. Testing can also be considered with a 2‐antibody panel on periocular sebaceous carcinoma in younger patients. Conclusions: Our findings align with known evidence supporting the need to incorporate clinical parameters in identifying patients at risk for MTS, with age being a factor when considering MMRP‐IHC testing.