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The epithelial cell adhesion molecule gene ( EPCAM , previously known as  TACSTD1  or  TROP1 ) encodes a membrane‐bound protein that is localized to the basolateral membrane of epithelial cells and is overexpressed in some tumors. Biallelic mutations in  EPCAM  cause congenital tufting enteropathy (CTE), which is a rare chronic diarrheal disorder presenting in infancy. Monoallelic deletions of the 3′ end of  EPCAM  that silence the downstream gene,  MSH2 , cause a form of Lynch syndrome, which is a cancer predisposition syndrome associated with loss of DNA mismatch repair. Here, we report 13 novel  EPCAM  mutations from 17 CTE patients from two separate centers, review  EPCAM  mutations associated with CTE and Lynch syndrome, and structurally model pathogenic missense mutations. Statistical analyses indicate that the c.499dupC (previously reported as c.498insC) frameshift mutation was associated with more severe treatment regimens and greater mortality in CTE, whereas the c.556‐14A>G and c.491+1G>A splice site mutations were not correlated with treatments or outcomes significantly different than random simulation. These findings suggest that genotype–phenotype correlations may be useful in contributing to management decisions of CTE patients. Depending on the type and nature of  EPCAM  mutation, one of two unrelated diseases may occur, CTE or Lynch syndrome.

EPCAM mutation update: Variants associated with congenital tufting enteropathy and Lynch syndrome