Our case was a 2-year-old boy who was incidentally diagnosed with anemia during the evaluation of an upper respiratory tract infection. There was no history of hematemesis, melena, or abdominal pain. The child was evaluated by the pediatric gastroenterologist with an upper gastrointestinal endoscopy and was found to have a large sessile gastric polyp that was not amenable to endoscopic resection. Physical examination was insignificant except for a few melanotic spots over the lower lip []. Radiological imaging revealed a large hyper-enhancing mass lesion in the lumen of the stomach, measuring about 8 cm in greatest dimension along with multiple small intestinal polyps. Laparotomy revealed a large sessile polyp involving the greater curvature and posterior wall of the stomach measuring about 10 cm × 8 cm along with multiple small sessile polyps involving the corpus of the stomach sparing the antrum and pylorus, requiring partial gastrectomy []. There were two more polyps, one each in the duodenum and distal jejunum in their antimesenteric border and they could be excised by enterotomy. The child had an uneventful postoperative course. The histopathology revealed the features of tubulovillous adenoma in all the resected polyps. At 36 months of follow-up, the child is asymptomatic and disease-free.
In 2003, a 40-year-old woman consulted a doctor because of feeling a palpable mass in the right breast and bleeding discharge from both breasts. Mammography was taken and revealed bilateral mass with infiltrating margins. Excisional biopsy was performed on both breasts. In histopatholgical examination, grossly; the right side showed a nonencapsulated mass with 5.0 × 4.0 × 1.0 cm size as well as relatively dense consistency and the left one showed the same mass with 6.0 × 3.0 × 2.0 cm size. In microscopic examination it was showed carcinoma in atypical sclerosing papilloma of both breasts [].\nOne month later bilateral modified radical mastectomy and axillary lymph nodes dissection were performed. In microscopic examination there was no residual of primary tumor and the only abnormality is atypical ductal hyperplasia. Lymph-nodes, skin, and nipple were free. Three months later a colonoscopy was performed and multiple polyps were found in the large bowel. Biopsy was taken and the result was hamartomatous polyp [].\nTwo years later in 2005, she was referred to the hospital again because of abnormal uterine bleeding (menometrorrhagia). Pelvic ultrasound showed increased endometrial thickness with normal adnexal regions. Bilateral salpingo-oophorectomy was performed. In histopathological examination, grossly, the uterus was measured 10.0 × 8.0 × 3.0 cm. The right ovary was measured 4.0 × 2.0 × 1.0 cm and the left one 4.0 × 3.0 × 1.0 cm. The cut surface of both ovaries showed nonhomogenous appearance with no obvious lesion. In microscopic examination, both ovaries showed sharply circumscribed rounded epithelial nests composed of ring-shaped tubules encircling the hyalinized basement membrane-like material. The nests have two basic patterns: The simple pattern is that of a single tubule encircling a central rounded hyaline mass, and the complex pattern is characterized by communicating tubules encircling multiple hyaline masses. These features are compatible with sex cord tumor with annular tubules that are usually associated with Peutz–Jeghers syndrome []. Except simple hyperplasia of endometrium; no any pathologic feature was found in the endometrium.