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This situation provides the opportunity to screen for visceral malignancies.[20] Diagnosis of MTS is based on clinical criteria, but it may be supported by IHC staining for MSH2 , MLH1 , and MSH6 , which can serve as a screening mechanism before molecular genetic analysis.[12,14-16,21] It is recommended that patients and family members with suspected MTS pursue genetic counseling/testing and appropriate visceral malignancy screening regimens