Common Characteristics of Bannayan-Ruvalcaba-Riley Syndrome

The most common characteristics of BRRS can be found in the table below. People with BRRS who have a mutation in the PTEN gene may also be at risk for the features associated with Cowden syndrome. Table 2 includes the common characteristics of Cowden syndrome.

Table 1: Common Characteristics of Bannayan-Ruvalcaba-Riley Syndrome (Please see the glossary for definitions of the terms.)

Class

Feature

Incidence

Growth

Birth Weight greater than 4 kg/9 lbs.

Majority

 

Birth Length Above the 97th percentile
(girls: 53 cm or 21 in, boys 55 cm or 21.5 in)

Majority

 

Normal Adult Height

Majority

Development

Low muscle tone (hypotonia)

50%

 

Motor Delay, Speech Delay, and/or
Mild Developmental Delay

50%

 

Myopathic process in proximal muscles

60%

 

Seizures

25%

Head

Macrocephaly

50%

Intestine

Hamartomatous polyps

45%

Skeletal

Joint hyperextensibility
Pectus Excavatum
Scoliosis

50%
50%
50%

Skin

Tan, nonelevated spots (freckling) on penis
Angiolipomas

Majority
50%

Tumors (benign)

Lipomas
Hemangiomas

75%
10-40%

Source: Gorlin RJ, Cohen MM, Condon LM, Burke BA. Bannayan-Riley-Ruvalcaba syndrome. Am J Med Gent 1992: 44: 307-314
Heald, B, Mester, J., Rybicki, L., Orloff, M.S., Burke, C.A, and Eng, C. Frequent Gastrointestinal Polyps and Colorectal Adenocarcinomas in Prospective Series of PTEN Mutation Carriers. Gastroenterology, epub 27 Jun 2010:
Jones, Kenneth Lyons. Smith's Recognizable Patterns of human Malformation. 5th Ed., WB Sanders Co 1997: 522-523.
Pilarski, R. Cowden syndrome: a Critical Review of the Clinical Literature. J Genet Counsel 2009;18:13-27.
Pilarski, R., Stephens, J., Noss, R., Fisher J.L. and Prior, T (2011). Predicting PTEN mutations: an evaluation of Cowden syndrome and Bannayan-Ruvalcaba-Riley syndrome clinical features. In press.

Table 2: Common Characteristics of Cowden Syndrome

Class

Feature

Incidence

Skin and mouth lesions

Trichilemmomas
Acral keratoses
Papillomatous papules

90-100%

Head

Macrocephaly

80%

Development

Mental retardation/developmental delay

15-20%

Thyroid problems

Goiter
Adenomas, nodules

40-60%

Breast Problems (females)

Fibroadenomas
Fibrocystic disease

40%

Gastrointestinal

Hamartomatous polyps, ganglioneuromas

80%

Gynecologic problems

Uterine fibroids (multiple and early onset)

25%

Other benign growths

Lipomas
Hemangiomas

40-50%
10-40%

Cancer

Thyroid Cancer
Breast Cancer
Endometrial Cancer

3-10%
25-50%
6-8%

Heald, B, Mester, J., Rybicki, L., Orloff, M.S., Burke, C.A, and Eng, C. Frequent Gastrointestinal Polyps and Colorectal Adenocarcinomas in Prospective Series of PTEN Mutation Carriers. Gastroenterology, epub 27 Jun 2010.
Pilarski, R. Cowden syndrome: a Critical Review of the Clinical Literature. J Genet Counsel 2009;18:13-27.
Pilarski, R., Stephens, J., Noss, R., Fisher J.L. and Prior, T (2011). Predicting PTEN mutations: an evaluation of Cowden syndrome and Bannayan-Ruvalcaba-Riley syndrome clinical features.

Robert Pilarski, MS, CGC, MSW, LSW Ohio State University
Joy Larsen Haidle, MS, CGC, Humphrey Cancer Center
Heather Hampel, MS, CGC, Ohio State University

Last Reviewed: September 2010

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