GALT/Dome Adenocarcinoma in a Patient With MLH1-Deficient Lynch Syndrome: Navigating a Clinical and Management Dilemma.

Authors

Vishal Deshpande, Ashish Sharma, Angad Tiwari, Jaya Sai Mupparaju, Tej Bodla, Dushyant Singh Dahiya

Published in

ACG case reports journal. Volume 13. Issue 8. Pages e02262. Epub Aug 14, 2026.

Abstract

A woman in her early 40s with MLH1-deficient Lynch syndrome was incidentally found to have a cecal gut-associated lymphoid tissue (GALT)/dome carcinoma during routine surveillance colonoscopy. This case highlights the co-occurrence of 2 rare entities: a germline MLH1 pathogenic variant and a GALT/dome carcinoma, now recognized within the lymphoglandular complex-like carcinoma spectrum, which carries potential for nodal metastasis. The intersection of mismatch repair deficiency and GALT/dome carcinoma raises a management dilemma: prophylactic colectomy vs endoscopic surveillance in the absence of high-risk histologic features. We review the literature to guide management in this rare scenario.

PMID:
42603041
Bibliographic data and abstract were imported from PubMed on 15 Aug 2026.

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