EGFR and Cowden disease: In CD biopsies both from GCD– and GFD–CD patients, increased activity of the EGFR (epidermal growth factor receptor)/EGF (epidermal growth factor) system and the downstream signaling molecule ERK (extracellular signal-regulated kinases) has been described [39,40,42] together with the enhancement of crypt enterocyte proliferation dependent on EGFR/ERK activation [39,40,42].