151
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van Engelen K, Villani A, Wasserman JD, Aronoff L, Greer MLC, Tijerin Bueno M, Gallinger B, Kim RH, Grant R, Meyn MS, Malkin D, Druker H. DICER1 syndrome: Approach to testing and management at a large pediatric tertiary care center. Pediatr Blood Cancer 2018; 65. [PMID: 28960912 DOI: 10.1002/pbc.26720] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 06/08/2017] [Accepted: 06/11/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND To expand the current knowledge of DICER1 syndrome and to propose criteria for genetic testing based on experience at a pediatric tertiary care center. PROCEDURE This study involved a retrospective chart review of the 78 patients (47 probands and 31 family members) seen in the Cancer Genetics Program at The Hospital for Sick Children (SickKids) who were offered genetic testing for DICER1. RESULTS Of 47 probands offered genetic testing for DICER1, 46 pursued testing: 11 (23.9%) carried a pathogenic variant and one proband (2.1%) carried a missense variant of uncertain significance with evidence for pathogenicity. Thirty-one family members of variant-positive probands were offered testing: eight of the 25 who agreed to testing carried their familial variant (32.0%). Overall, 20 patients were identified to have a variant in DICER1 (eight males, 12 females). Of these, 13 (65.0%) presented with clinical manifestations associated with the syndrome. The most common lesions were pleuropulmonary blastoma (PPB) (five of 20 patients, 25.0%) and pineoblastoma (three of 20 patients, 15.0%). The average age at which individuals were diagnosed with a primary neoplasm was 5.2 years (range 0.8-20 years, median 3.0). Surveillance at our institution, with a median follow-up time of 23 months, has identified PPB in two asymptomatic individuals. These lesions were identified at early stages, thus potentially reducing treatment-related morbidity and mortality. CONCLUSION This study further delineates the DICER1 syndrome phenotype and demonstrates the feasibility of a DICER1 syndrome surveillance protocol for the early detection of tumors.
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Affiliation(s)
- Kalene van Engelen
- Genetics and Genome Biology Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Anita Villani
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan D Wasserman
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Division of Endocrinology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Laura Aronoff
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Mary-Louise C Greer
- Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Marta Tijerin Bueno
- Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Bailey Gallinger
- Genetics and Genome Biology Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Genetic Counselling, University of Toronto, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Raymond H Kim
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada.,Division of Medical Oncology and Hematology, Princess Margaret Cancer Center, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ronald Grant
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - M Stephen Meyn
- Genetics and Genome Biology Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.,Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - David Malkin
- Genetics and Genome Biology Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Harriet Druker
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Genetic Counselling, University of Toronto, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
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152
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Li S, Cai S, Wang X, Zhang D, Fu L, Zeng Q, Peng X, Ma X. A pair of DICER1-positive monozygotic twins: One with pleuropulmonary blastoma, another with acute transient hepatitis. Pediatr Blood Cancer 2017; 64. [PMID: 28688118 DOI: 10.1002/pbc.26680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 05/14/2017] [Accepted: 05/15/2017] [Indexed: 11/12/2022]
Abstract
Pleuropulmonary blastoma (PPB) is the most common primary malignant neoplasm of the lung in children that is associated with a germline mutation in DICER1. In this report, we share an interesting case of a pair of monozygotic twins: one of them developed PPB when she was 4-year old, while the other developed acute transient hepatitis when she was 5-year old. Next-Gen sequencing for DICER1 mutations of their family revealed that both twins and their mother had c.C3675A mutation. The mother also had a history of multinodular goiter. Identification of DICER1 mutation carriers and close surveillance of individuals at risk for DICER1 syndrome may allow early detection and hence better outcome.
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Affiliation(s)
- Sihui Li
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Siyu Cai
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Xisi Wang
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Dawei Zhang
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Libing Fu
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Qi Zeng
- Department of Pediatric Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Xiaoxia Peng
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Xiaoli Ma
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, MOE Key Laboratory of Major Diseases in Children, Beijing, China
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153
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Leblanc C, Baron M, Desselas E, Phan MH, Rybak A, Thouvenin G, Lauby C, Irtan S. Congenital pulmonary airway malformations: state-of-the-art review for pediatrician's use. Eur J Pediatr 2017; 176:1559-1571. [PMID: 29046943 DOI: 10.1007/s00431-017-3032-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/30/2017] [Accepted: 10/04/2017] [Indexed: 02/06/2023]
Abstract
UNLABELLED Congenital pulmonary airway malformations or CPAM are rare developmental lung malformations, leading to cystic and/or adenomatous pulmonary areas. Nowadays, CPAM are diagnosed prenatally, improving the prenatal and immediate postnatal care and ultimately the knowledge on CPAM pathophysiology. CPAM natural evolution can lead to infections or malignancies, whose exact prevalence is still difficult to assess. The aim of this "state-of-the-art" review is to cover the recently published literature on CPAM management whether the pulmonary lesion was detected during pregnancy or after birth, the current indications of surgery or surveillance and finally its potential evolution to pleuro-pulmonary blastoma. CONCLUSION Surgery remains the cornerstone treatment of symptomatic lesions but the postnatal management of asymptomatic CPAM remains controversial. There are pros and cons of surgical resection, as increasing rate of infections over time renders the surgery more difficult after months or years of evolution, as well as risk of malignancy, though exact incidence is still unknown. What is known: • Congenital pulmonary airway malformations (CPAM) are rare developmental lung malformations mainly antenatally diagnosed. • While the neonatal management of symptomatic CPAM is clear and includes prompt surgery, controversies remain for asymptomatic CPAM due to risk of infections and malignancies. What is new: • Increased rate of infection over time renders the surgery more difficult after months or years of evolution and pushes for recommendation of early elective surgery. • New molecular or pathological pathways may help in the distinction of type 4 CPAM from type I pleuropulmonary blastoma.
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Affiliation(s)
- Claire Leblanc
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Marguerite Baron
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Emilie Desselas
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Minh Hanh Phan
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Alexis Rybak
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Guillaume Thouvenin
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France.,UPMC Univ Paris 06, Centre de Recherche St Antoine Inserm UMRS.938, Sorbonne Universités, Paris, France
| | - Clara Lauby
- Department of Pediatric Pulmonology, APHP Hôpital Armand Trousseau, Paris, France
| | - Sabine Irtan
- UPMC Univ Paris 06, Centre de Recherche St Antoine Inserm UMRS.938, Sorbonne Universités, Paris, France. .,Department of Pediatric Surgery, APHP Hôpital Armand Trousseau, 26 avenue du Dr Arnold Netter, 75012, Paris, France.
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154
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Neonatal congenital lung tumors - the importance of mid-second-trimester ultrasound as a diagnostic clue. Pediatr Radiol 2017; 47:1766-1775. [PMID: 28884206 DOI: 10.1007/s00247-017-3953-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/10/2017] [Accepted: 07/18/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND The differential diagnosis for primary lung masses in neonates includes a variety of developmental abnormalities; it also consists of the much rarer congenital primary lung tumors: cystic pleuropulmonary blastoma (cystic PPB), fetal lung interstitial tumor (FLIT), congenital peribronchial myofibroblastic tumor (CPMT), and congenital fibrosarcoma. Radiologic differentiation between malformations and tumors is often very challenging. OBJECTIVE The objective was to establish distinctive features between developmental pulmonary abnormalities and primary lung tumors. MATERIALS AND METHODS We conducted a retrospective study of 135 congenital lung lesions at a university mother and child center over a period of 10 years (2005-2015). During this time, we noted four tumors (two cystic PPBs and two FLITs) and 131 malformations. We recorded the following parameters: timing of conspicuity in utero (mid-second trimester, third trimester, or not seen prenatally), presence of symptoms at birth, prenatal and perinatal radiologic findings, and either histological diagnoses by pathology or follow-up imaging in non-operated cases. RESULTS All lesions except the four tumors were detected during mid-second-trimester ultrasound. In none of the tumors was any pulmonary abnormality found on the mid-second-trimester sonogram, contrary to the developmental pulmonary abnormalities. CONCLUSION The timing of conspicuity in utero appears to be a key feature for the differentiation between malformations and tumors. Lesions that were not visible at the mid-second-trimester ultrasound should be considered as tumor. A cystic lung lesion in the context of a normal mid-second-trimester ultrasound is highly suggestive of a cystic PPB. Differentiating the types of solid congenital lung tumors based upon imaging features is not yet feasible.
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155
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Kim J, Field A, Schultz KAP, Hill DA, Stewart DR. The prevalence of DICER1 pathogenic variation in population databases. Int J Cancer 2017; 141:2030-2036. [PMID: 28748527 PMCID: PMC5749397 DOI: 10.1002/ijc.30907] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/03/2017] [Accepted: 07/18/2017] [Indexed: 12/26/2022]
Abstract
The DICER1 syndrome is associated with a variety of rare benign and malignant tumors, including pleuropulmonary blastoma (PPB), cystic nephroma (CN) and Sertoli-Leydig cell tumor (SLCT). The prevalence and penetrance of pathogenic DICER1 variation in the general population is unknown. We examined three publicly-available germline whole exome sequence datasets: Exome Aggregation Consortium (ExAC), 1,000 Genomes (1,000 G) and the Exome Sequencing Project (ESP). To avoid over-estimation of pathogenic DICER1 variation from cancer-associated exomes, we excluded The Cancer Genome Atlas (TCGA) variants from ExAC. All datasets were annotated with snpEff and ANNOVAR and variants were classified into four categories: likely benign (LB), unknown significance (VUS), likely pathogenic (LP), or pathogenic (P). The prevalence of DICER1 P/LP variants was 1:870 to 1:2,529 in ExAC-nonTCGA (53,105 exomes) estimated by metaSVM and REVEL/CADD, respectively. A more stringent prevalence calculation considering only loss-of-function and previously-published pathogenic variants detected in ExAC-nonTCGA, yielded a prevalence of 1:10,600. Despite the rarity of most DICER1 syndrome tumors, pathogenic DICER1 variation is more common than expected. If confirmed, these findings may inform future sequencing-based newborn screening programs for PPB, CN and SLCT, in which early detection improves prognosis.
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Affiliation(s)
- Jung Kim
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Amanda Field
- Division of Pathology and Center for Genetic Medicine Research, Children’s National Health System, Washington, DC
| | - Kris Ann P. Schultz
- Cancer and Blood Disorders, Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN
- International Pleuropulmonary Blastoma Registry, Minneapolis, MN
- International Ovarian and Testicular Stromal Tumor Registry, Minneapolis, MN
| | - D. Ashley Hill
- Division of Pathology and Center for Genetic Medicine Research, Children’s National Health System, Washington, DC
- Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Douglas R. Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
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156
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Dillman JR, Trout AT, Smith EA, Towbin AJ. Hereditary Renal Cystic Disorders: Imaging of the Kidneys and Beyond. Radiographics 2017; 37:924-946. [PMID: 28493804 DOI: 10.1148/rg.2017160148] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The purpose of this article is to review the hereditary renal cystic diseases that can manifest in children and adults, with specific attention to pathogenesis and imaging features. Various common and uncommon hereditary renal cystic diseases are reviewed in terms of their underlying etiology, including the involved genetic mutations and the affected proteins and cellular structures. Focus is placed on the morphologic findings in each condition and the features that distinguish one disorder from another. The two most common categories of hereditary renal cystic disease are (a) the ciliopathic disorders, which are related to mutations affecting the primary cilia (called "ciliopathies"), and (b) the phakomatoses. Autosomal dominant polycystic kidney disease, autosomal recessive polycystic kidney disease, and the "medullary cystic disease complex" are all ciliopathies but have different phenotypes. Tuberous sclerosis complex and the associated "contiguous gene syndrome," as well as von Hippel-Lindau syndrome, are phakomatoses that can manifest with cystic renal lesions but have uniquely different extrarenal manifestations. Finally, DICER1 mutations can manifest with renal cystic lesions (typically, cystic nephromas) in patients predisposed to other malignancies in the chest, ovaries, and thyroid. Although some overlap exists in the appearance of the renal cysts associated with each of these diseases, there are clear morphologic differences (eg, cyst size, location, and complexity) that are emphasized in this review. To improve patient outcomes, it is important for the radiologist to recognize the various hereditary renal cystic diseases so that a correct diagnosis is assigned and so that the patient is adequately evaluated and followed up. ©RSNA, 2017.
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Affiliation(s)
- Jonathan R Dillman
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (J.R.D., A.T.T., A.J.T.); and the Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (E.A.S.)
| | - Andrew T Trout
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (J.R.D., A.T.T., A.J.T.); and the Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (E.A.S.)
| | - Ethan A Smith
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (J.R.D., A.T.T., A.J.T.); and the Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (E.A.S.)
| | - Alexander J Towbin
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (J.R.D., A.T.T., A.J.T.); and the Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (E.A.S.)
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157
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Vokuhl C, de Leon-Escapini L, Leuschner I. Strong Expression and Amplification of IGF1R in Pleuropulmonary Blastomas. Pediatr Dev Pathol 2017; 20:475-481. [PMID: 28382840 DOI: 10.1177/1093526617700945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pleuropulmonary blastoma (PPB) is a rare malignant intrathoracic tumor primarily affecting children under 5 years of age. PPBs are histologically divided into 3 subtypes: Type 1 PPBs are composed of multiple cysts, and type 3 is a solid lesion with a variable morphologic appearance. Type 2 has a mixed morphology consisting of cystic and solid areas. The genetics of PPB are poorly understood. We analyzed 16 cases of the Kiel Paediatric Tumor Registry with the diagnosis of PPB by comparative genomic hybridization and confirmed some genetic changes by fluorescence in situ hybridization. Furthermore, we performed immunohistochemistry to evaluate insulin-like growth factor type 1 (IGF1R) protein expression. Frequent findings by comparative genomic hybridization were losses on 4q, 5q, 9p and gains on chromosome 8, 17, and 20q. Genomic amplification was observed in 5 cases, 4 related to 15q25qter and 1 to 1p. Fluorescence in situ hybridization could confirm 7 gains of chromosome 8 (7/16, 44%) and 4 amplifications of the IGF1R-gene on 15q26 (4/16, 25%). All of the tumors with IGF1R amplification were type 3 PPBs. One of the PPBs with gain of chromosome 8 was a type 2 tumor and 6 tumors were type 3 PPBs. All but one PPB showed an IGF1R expression by immunohistochemistry. In our series of 16 PPBs, 25% of the tumors have an amplification of the IGF1R gene and 44% show a gain of chromosome 8. All of the tumors with IGF1R amplification were PPBs type 3, indicating that it is a later event in tumor progression, while the gain of chromosome 8 was found in both type 2 and type 3 tumors indicating that these changes are probably earlier events in tumor development. Furthermore, the strong IGF1R protein expression could be a possible therapeutic target in refractory chemoresistant PPBs.
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Affiliation(s)
- Christian Vokuhl
- 1 Department of Pediatric Pathology, Christian-Albrechts-University Kiel, Kiel, Germany
| | | | - Ivo Leuschner
- 1 Department of Pediatric Pathology, Christian-Albrechts-University Kiel, Kiel, Germany
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158
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Pierce JM, LaCroix P, Heym K, Bowman WP, Margraf L, Iglesias J, Ray A. Pleuropulmonary Blastoma: A Single-center Case Series of 6 Patients. J Pediatr Hematol Oncol 2017; 39:e419-e422. [PMID: 28991133 DOI: 10.1097/mph.0000000000000972] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pleuropulmonary blastoma (PPB) is a rare malignancy of childhood which when left untreated often shows pathologic progression resulting in a more aggressive neoplasm with an increasingly poor prognosis. Because of this it is important to diagnose and initiate treatment early. However, early stage PPB can appear as a cystic lung lesion on imaging and can be easily misdiagnosed given the rarity of the malignancy. Moreover, current therapeutic guidelines for these lesions are not well established, making treatment decisions and management difficult for clinicians. DICER1 mutations are known to be present in a majority of PPBs with or without a germline mutation and may be part of a familial tumor predisposition syndrome. The clinical, pathologic, and genetic data of 6 patients are summarized here. Two patients with type I PPB and 4 patients with type II PPB underwent surgical and chemotherapeutic treatment and all are alive and without recurrence 1 to 13 years after treatment. With increasing awareness of PPB, it is important for clinicians to consider this malignant entity in the evaluation and treatment of patients presenting with a cystic lung abnormality, especially in cases with a history strongly suggestive of a DICER1 mutation.
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Affiliation(s)
- Janie M Pierce
- *Department of Pediatrics, Texas College of Osteopathic Medicine Departments of ‡Hematology and Oncology §Pathology ∥Surgery, Cook Children's Medical Center, Fort Worth, TX †Department of Pediatrics, Arkansas Children's Hospital, Little Rock, AR
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159
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Schultz KAP, Harris AK, Finch M, Dehner LP, Brown JB, Gershenson DM, Young RH, Field A, Yu W, Turner J, Cost NG, Schneider DT, Stewart DR, Frazier AL, Messinger Y, Hill DA. DICER1-related Sertoli-Leydig cell tumor and gynandroblastoma: Clinical and genetic findings from the International Ovarian and Testicular Stromal Tumor Registry. Gynecol Oncol 2017; 147:521-527. [PMID: 29037807 DOI: 10.1016/j.ygyno.2017.09.034] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/25/2017] [Accepted: 09/28/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Ovarian sex cord-stromal tumors (OSCST) include juvenile granulosa cell tumors (JGCT), Sertoli-Leydig cell tumor (SLCT) and gynandroblastoma (GAB) among others. These ovarian sex cord-stromal tumors as well as other tumors including pleuropulmonary blastoma (PPB) may be associated with DICER1 mutations. We sought to describe the clinical and genetic findings from the first 107 individuals enrolled in the International Ovarian and Testicular Stromal Tumor Registry. METHODS Medical and family history were obtained for individuals consecutively enrolled in the International Ovarian and Testicular Stromal Tumor Registry. Pathology was centrally reviewed. DICER1 sequencing was performed on blood and tumor tissue. RESULTS Of the 107 participants, 49 had SLCT, 25 had JGCT and 5 had GAB. Nearly all (36/37) SLCTs and 4/4 GAB tested had a DICER1 mutation in an RNase IIIb domain hotspot; approximately half of these individuals had a predisposing germline DICER1 mutation. Metachronous SLCTs were seen in 3 individuals with germline DICER1 mutations. Other DICER1-associated conditions were seen in 19% of patients with SLCT or GAB. Three children of women with SLCT were diagnosed with PPB based on genetic testing and clinical screening during the course of this study. All were diagnosed with PPB in its earliest and most curable form (Type I), were treated with surgery alone, and are alive without evidence of disease. CONCLUSIONS Recognition of the distinct genetic basis for a group of these tumors improves precise classification in difficult cases and promotes mutation-based screening and early detection.
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Affiliation(s)
- Kris Ann P Schultz
- International Ovarian and Testicular Stromal Tumor Registry, Children's Minnesota, Minneapolis, MN, United States; Cancer and Blood Disorders, Children's Minnesota, Minneapolis, MN, United States.
| | - Anne K Harris
- International Ovarian and Testicular Stromal Tumor Registry, Children's Minnesota, Minneapolis, MN, United States; Cancer and Blood Disorders, Children's Minnesota, Minneapolis, MN, United States
| | - Michael Finch
- Children's Minnesota Research Institute, Children's Minnesota, Minneapolis, MN, United States
| | - Louis P Dehner
- International Ovarian and Testicular Stromal Tumor Registry, Children's Minnesota, Minneapolis, MN, United States; Lauren V. Ackerman Division of Surgical Pathology, Washington University Medical Center, St. Louis, MO, United States
| | - Jubilee B Brown
- Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, United States
| | - David M Gershenson
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Robert H Young
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Amanda Field
- Department of Pathology and Center for Cancer & Immunology Research, Children's National Medical Center, Washington, DC, 20010, United States; Center for Genetic Medicine Research, Children's Research Institute, United States
| | - Weiying Yu
- Department of Pathology and Center for Cancer & Immunology Research, Children's National Medical Center, Washington, DC, 20010, United States
| | - Joyce Turner
- Division of Genetics, Children's National Medical Center, George Washington University School of Medicine & Health Sciences, Washington, DC, United States
| | - Nicholas G Cost
- International Ovarian and Testicular Stromal Tumor Registry, Children's Minnesota, Minneapolis, MN, United States; Department of Surgery, Division of Urology, University of Colorado School of Medicine, Aurora, CO, United States
| | | | - Douglas R Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD
| | - A Lindsay Frazier
- International Ovarian and Testicular Stromal Tumor Registry, Children's Minnesota, Minneapolis, MN, United States; Dana-Farber Cancer Institute/Children's Cancer and Blood Disorders Center, Boston, MA, United States
| | - Yoav Messinger
- International Ovarian and Testicular Stromal Tumor Registry, Children's Minnesota, Minneapolis, MN, United States; Cancer and Blood Disorders, Children's Minnesota, Minneapolis, MN, United States
| | - D Ashley Hill
- International Ovarian and Testicular Stromal Tumor Registry, Children's Minnesota, Minneapolis, MN, United States; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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160
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Schultz KAP, Harris AK, Schneider DT, Young RH, Brown J, Gershenson DM, Dehner LP, Hill DA, Messinger YH, Frazier AL. Ovarian Sex Cord-Stromal Tumors. J Oncol Pract 2017; 12:940-946. [PMID: 27858560 DOI: 10.1200/jop.2016.016261] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Ovarian sex cord-stromal tumors are clinically significant heterogeneous tumors that include several pathologic types. These tumors are often found in adolescents and young adults and can present with hormonal manifestations as well as signs and symptoms of a pelvic mass. Serum tumor markers may assist in preoperative diagnosis and surveillance. Several subtypes are associated with genetic predisposition, including those observed in patients with Peutz-Jegher syndrome. Recent studies have elucidated the relationship between Sertoli-Leydig cell tumors and DICER1 mutations. When classified as International Federation of Gynecology and Obstetrics stage Ia, most subtypes may be treated with surgery alone. Higher stage or recurrent tumors have variable prognoses that range from a usually rapid course in poorly differentiated Sertoli-Leydig cell tumor to an often prolonged course in adult granulosa cell tumors. New understanding of the molecular pathogenesis of these tumors may pave the way for novel therapeutics.
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Affiliation(s)
- Kris Ann P Schultz
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Anne K Harris
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Dominik T Schneider
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Robert H Young
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Jubilee Brown
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - David M Gershenson
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Louis P Dehner
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - D Ashley Hill
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Yoav H Messinger
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - A Lindsay Frazier
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
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161
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Luke AM, Moroney JW, Snitchler A, Whiteway SL. Ovarian Sertoli-Leydig Cell Tumor with Elevated Inhibin B as a Cause of Secondary Amenorrhea in an Adolescent with Germ Line DICER1 Mutation. J Pediatr Adolesc Gynecol 2017; 30:598-600. [PMID: 28502826 DOI: 10.1016/j.jpag.2017.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 04/25/2017] [Accepted: 05/02/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Ovarian tumors, although uncommon in children, can retain endocrine function that disrupts normal feedback mechanisms leading to amenorrhea. Inheritance of germline DICER1 mutations can lead to increased risk for development of ovarian Sertoli-Leydig cell tumors (SLCTs). CASE We report, to our knowledge, the first case of secondary amenorrhea due to elevated inhibin B levels in a female adolescent with an ovarian SLCT. SUMMARY AND CONCLUSION Ovarian tumors should be included in the differential diagnosis for pediatric patients who present with menstrual irregularities. Early evaluation of the hypothalamic-pituitary-ovarian axis and inhibin levels is appropriate. Our case also emphasizes the need for testing for DICER1 mutations in pediatric patients with ovarian SLCTs.
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Affiliation(s)
- Amy M Luke
- San Antonio Uniformed Services Health Education Consortium, JBSA, Fort Sam Houston, San Antonio, Texas
| | - John W Moroney
- University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | | | - Susan L Whiteway
- San Antonio Uniformed Services Health Education Consortium, JBSA, Fort Sam Houston, San Antonio, Texas.
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162
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Shuja J, Ahmad I, Ahmad K, Manzoor H, Kakar S, Sadiq M, Ahmad M, Marri M, Naheed H. Pleuropulmonary blastoma. JOURNAL OF CANCER RESEARCH AND PRACTICE 2017. [DOI: 10.1016/j.jcrpr.2017.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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163
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Cook J, Chitty LS, De Coppi P, Ashworth M, Wallis C. The natural history of prenatally diagnosed congenital cystic lung lesions: long-term follow-up of 119 cases. Arch Dis Child 2017; 102:798-803. [PMID: 28584070 DOI: 10.1136/archdischild-2016-311233] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND A paucity of evidence regarding the natural history of congenital pulmonary airway malformations (CPAMs) and pulmonary sequestration (PS) has resulted in a divergence in management strategy of asymptomatic cases. METHODS We describe the long-term clinical course of 119 children diagnosed with these lesions treated at Great Ormond Street Hospital (GOSH). Cases were identified via the GOSH patient database. Study entry required the identification of a cystic lung lesion on prenatal ultrasound and confirmation of CPAM/PS on postnatal CT imaging. Patients followed up for at least 5 years were included. RESULTS 51 (43%) patients were managed surgically; 8 (6.7%) as an emergency during the neonatal period, 6 (5.1%) electively due to concerning features on CT scan, 20 (17%) following medical advice, 1 (0.8%) following a severe respiratory infection and in 5 (4.2%) the indication was unclear. The indication in 11 (9.2%) was recurrent respiratory infection and median age at surgery was 1.6 years (range 0.4 to 4.6 years). No cases of malignancy were identified on histological examination of resected lesions. 68 (57%) patients were managed conservatively for a median period of 9.9 years (range 5.2 years to 18 years). Seven (10%) were discharged, one was followed-up elsewhere (1.5%) and eight (11%) were lost to follow-up. In four patients (5.9%), the lesion resolved spontaneously. 52 (76%) continue to be followed-up and remain asymptomatic. CONCLUSIONS This is one of the largest case series documenting the natural history of CPAMs and PS following a prenatal diagnosis and demonstrates that conservative management is a reasonable option in selected cases.
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Affiliation(s)
- James Cook
- Department of Paediatric Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Lyn S Chitty
- Department of Fetal Medicine, University College Hospitals NHS Foundation Trust, London, UK.,Genetics and Genomic Medicine Section, Institute of Child Health, University College London, London, UK.,Department of Clinical Genetics, Great Ormond Street Hospital for Children NHS Foundation Trust, London
| | - Paolo De Coppi
- Department of Paediatric Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Stem Cells and Regenerative Medicine Section, Institute of Child Health, University College London, London
| | - Michael Ashworth
- Department of Pathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Colin Wallis
- Department of Paediatric Respiratory Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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164
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Bueno MT, Martínez-Ríos C, la Puente Gregorio AD, Ahyad RA, Villani A, Druker H, van Engelen K, Gallinger B, Aronoff L, Grant R, Malkin D, Greer MLC. Pediatric imaging in DICER1 syndrome. Pediatr Radiol 2017; 47:1292-1301. [PMID: 28474256 DOI: 10.1007/s00247-017-3875-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 02/26/2017] [Accepted: 04/20/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND DICER1 syndrome, arising from a mutation in the DICER1 gene mapped to chromosome 14q32, is associated with an increased risk of a range of benign and malignant neoplasms. OBJECTIVE To determine the spectrum of abnormalities and imaging characteristics in patients with DICER1 syndrome at a tertiary pediatric hospital. MATERIALS AND METHODS This retrospective analysis evaluated imaging in patients ≤18 years with DICER1 germline variants between January 2004 and July 2016. An imaging database search including keywords pleuropulmonary blastoma, cystic nephroma, pineoblastoma, embryonal rhabdomyosarcoma, ovarian sex cord-stromal tumor, ovarian Sertoli-Leydig cell tumor and DICER1 syndrome, was cross-referenced against the institutional Cancer Genetics Program database, excluding patients with negative/unknown DICER1 gene testing. RESULTS Sixteen patients were included (12 females; mean age at presentation: 4.2 years, range: 14 days to 17 years), with surveillance imaging encompassing the following modalities: chest X-ray and CT; abdominal, pelvic and neck US; and brain and whole-body MRI. Malignant lesions (68.8% of patients) included pleuropulmonary blastoma (5), pineoblastoma (3), ovarian Sertoli-Leydig cell tumor (1), embryonal rhabdomyosarcoma (1) and renal sarcoma (1); benign lesions (37.5% of patients) included thyroid cysts (2), thyroid nodules (2), cystic nephroma (2), renal cysts (1) and pineal cyst (1). A common lesional appearance observed across modalities and organs was defined as the "cracked windshield" sign. CONCLUSION The spectrum of DICER1-related tumors and the young age at presentation suggest early surveillance of at-risk patients is critical, while minimizing exposure to ionizing radiation.
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Affiliation(s)
- Marta Tijerin Bueno
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Claudia Martínez-Ríos
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | | | - Rayan A Ahyad
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Anita Villani
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Harriet Druker
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kalene van Engelen
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bailey Gallinger
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Laura Aronoff
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ronald Grant
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - David Malkin
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mary-Louise C Greer
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada.
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
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165
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Abstract
The nucleolus is a distinct compartment of the nucleus responsible for ribosome biogenesis. Mis-regulation of nucleolar functions and of the cellular translation machinery has been associated with disease, in particular with many types of cancer. Indeed, many tumor suppressors (p53, Rb, PTEN, PICT1, BRCA1) and proto-oncogenes (MYC, NPM) play a direct role in the nucleolus, and interact with the RNA polymerase I transcription machinery and the nucleolar stress response. We have identified Dicer and the RNA interference pathway as having an essential role in the nucleolus of quiescent Schizosaccharomyces pombe cells, distinct from pericentromeric silencing, by controlling RNA polymerase I release. We propose that this novel function is evolutionarily conserved and may contribute to the tumorigenic pre-disposition of DICER1 mutations in mammals.
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Affiliation(s)
- Benjamin Roche
- a Martienssen Lab, Cold Spring Harbor Laboratory , Cold Spring Harbor , NY , USA
| | - Benoît Arcangioli
- b Genome Dynamics Unit, UMR 3525 CNRS, Institut Pasteur , Paris , France
| | - Rob Martienssen
- a Martienssen Lab, Cold Spring Harbor Laboratory , Cold Spring Harbor , NY , USA.,c Howard Hughes Medical Institute, Cold Spring Harbor Laboratory , Cold Spring Harbor , NY , USA
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166
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Fita AM, Llinares-Riestra E, Doménech-Abellán E, Bermúdez-Cortés M, Galera-Miñarro AM, Bas-Bernal A, Fuster-Soler JL. Type III pleuropulmonary blastoma in a dicer1 germline mutation carrier: The management of residual lung cystic lesions. Pediatr Blood Cancer 2017; 64. [PMID: 28097783 DOI: 10.1002/pbc.26438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 12/05/2016] [Accepted: 12/07/2016] [Indexed: 11/08/2022]
Abstract
Pleuropulmonary blastoma (PPB) is a rare malignancy of childhood. It often represents a manifestation of a hereditary tumor predisposition syndrome (DICER1 syndrome). Because of its malignant potential, surgical resection of cystic lung lesions is recommended in germline DICER1 mutation carriers. We present a case of a 3-year-old male child with type III PPB successfully managed with ifosfamide, vincristine, actinomycin-D, and doxorubicin (IVADo) chemotherapy and surgery. A heterozygous germline pR688X mutation of DICER1 gene was demonstrated. Six years after primary diagnosis, several small lung cysts remained stable without further therapy. The management of residual asymptomatic lung cysts represents a clinical challenge in these patients.
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Affiliation(s)
- Ana M Fita
- Department of Pediatric Hematology and Oncology, University Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Esther Llinares-Riestra
- Department of Pediatric Hematology and Oncology, University Hospital Virgen de la Arrixaca, Murcia, Spain
| | | | - Mar Bermúdez-Cortés
- Department of Pediatric Hematology and Oncology, University Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Ana M Galera-Miñarro
- Department of Pediatric Hematology and Oncology, University Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Agueda Bas-Bernal
- Department of Anatomical Pathology, University Hospital Virgen de la Arrixaca, Murcia, Spain
| | - José L Fuster-Soler
- Department of Pediatric Hematology and Oncology, University Hospital Virgen de la Arrixaca, Murcia, Spain
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167
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168
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Abstract
It has been reported that germline DICER1 mutations correlate with a distinctive human disease syndrome. Many published studies within this field have been conducted based on rare cases. We systematically searched bibliographic databases, including PubMed, Embase, and COSMIC for articles which are related to diseases covered by DICER1 syndrome. The weighted summary of mutation frequencies among patients with pleuropulmonary blastoma (PPB), cystic nephroma (CN), and Sertoli-Leydig cell tumor (SLCT) were calculated. Forty-nine eligible articles were included. In total, 72 cases with multimorbidity of DICER1 syndrome were identified. More females (n=46, 64%) presented with multimorbidity than males (n=18, 25%) and the remaining 8 patients' sex were unknown. Nineteen of 72 patients with multimorbidity suffered from another disease that was not yet included in DICER1 syndrome, which would provide potential phenotypes of DICER1 syndrome. The germline DICER1 mutation frequencies in PPB, CN, and SLCT were 66.9%, 73.2%, and 57.1%, respectively. The somatic DICER1 mutation frequencies of PPB, CN, and SLCT were 92.4%, 87.9%, and 43.3%, respectively. Majority of patients with multimorbidity of DICER1 syndrome were mutation positive individuals so that multimorbidity may suggest the possible germline mutation of these patients and their relatives.
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169
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Cai S, Wang X, Zhao W, Fu L, Ma X, Peng X. DICER1 mutations in twelve Chinese patients with pleuropulmonary blastoma. SCIENCE CHINA-LIFE SCIENCES 2017. [PMID: 28624956 DOI: 10.1007/s11427-017-9081-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Our aim is to examine the impact of DICER1 mutations on the pathogenesis of pleuropulmonary blastoma (PPB) by evaluating the mutation frequency and investigating the family history of Chinese patients with PPB. The family histories of 12 children with PPB recruited consecutively were surveyed. Blood samples from patients and their first-degree relatives were tested for DICER1 mutations. Whole-genome sequencing of blood samples and formalin-fixed and paraffin-embedded (FFPE) tumor tissue was performed in one family with twins. Twelve patients with PPB included six type II and six type III cases. Seven of the 12 patients harbored DICER1 mutations, six of which were frameshift or nonsense mutations. Another case carried a germline DICER1 mutation affecting the splice site. FFPE sample had a nonsense mutation in TDG and missense mutations in DICER1. In addition, two cases with DICER1 mutations were found to have lung cysts preceding the diagnosis of PPB. Furthermore, one patient had a family history remarkable for thyroid diseases. Our results indicate that the germline mutation frequency in Chinese patients with PPB is similar to the ones reported for patients from USA, UK, and Japan. Moreover, our study strongly suggests that investigating the family history and detecting germline DICER1 mutations might be of benefit to increasing awareness and improving the accuracy of the differential diagnosis of PPB from non-malignant lung cysts.
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Affiliation(s)
- Siyu Cai
- Center for Clinical Epidemiology & Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Xisi Wang
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Wen Zhao
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Libing Fu
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Xiaoli Ma
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China. .,Beijing Key Laboratory of Pediatric Hematology Oncology, Beijing, 100045, China. .,Key Laboratory of Major Diseases in Children, Ministry of Education, Beijng, 100045, China.
| | - Xiaoxia Peng
- Center for Clinical Epidemiology & Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China. .,Key Laboratory of Major Diseases in Children, Ministry of Education, Beijng, 100045, China.
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170
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Haider F, Al Saad K, Al-Hashimi F, Al-Hashimi H. It's Rare So Be Aware: Pleuropulmonary Blastoma Mimicking Congenital Pulmonary Airway Malformation. Thorac Cardiovasc Surg Rep 2017; 6:e10-e14. [PMID: 28405541 PMCID: PMC5388606 DOI: 10.1055/s-0037-1598625] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Pleuropulmonary blastoma (PPB) is a rare aggressive malignant tumor of infancy and early childhood. The tumor arises in the lung and pleura and is regarded as a pulmonary dysontogenetic or embryonic neoplasm. Four types are defined in literature. Type I PPB is a rare, cystic lung neoplasm in infants characterized by subtle malignant changes and a good prognosis. Recurrences after type I PPB are usually advanced with a poor prognosis. We report this case to increase awareness about this entity so that the pediatricians, pediatric surgeons, radiologist, and pathologist recognize it early.
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Affiliation(s)
- Fayza Haider
- Pediatric Surgery Unit, Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
| | - Khulood Al Saad
- Pediatric Department, Salmaniya Medical Complex, Manama, Bahrain
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171
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Scollon S, Anglin AK, Thomas M, Turner JT, Wolfe Schneider K. A Comprehensive Review of Pediatric Tumors and Associated Cancer Predisposition Syndromes. J Genet Couns 2017; 26:387-434. [PMID: 28357779 DOI: 10.1007/s10897-017-0077-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 01/30/2017] [Indexed: 12/11/2022]
Abstract
An understanding of the role of inherited cancer predisposition syndromes in pediatric tumor diagnoses continues to develop as more information is learned through the application of genomic technology. Identifying patients and their relatives at an increased risk for developing cancer is an important step in the care of this patient population. The purpose of this review is to highlight various tumor types that arise in the pediatric population and the cancer predisposition syndromes associated with those tumors. The review serves as a guide for recognizing genes and conditions to consider when a pediatric cancer referral presents to the genetics clinic.
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Affiliation(s)
- Sarah Scollon
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Cancer Center, Texas Children's Hospital, 1102 Bates St, FC 1200, Houston, TX, 77030, USA.
| | | | | | - Joyce T Turner
- Department of Genetics and Metabolism, Children's National Medical Center, Washington, DC, USA
| | - Kami Wolfe Schneider
- Department of Pediatrics, University of Colorado, Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO, USA
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172
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Ferrari A, Schneider DT, Bisogno G, Orbach D, Villarroel M, Giron V, Rodriguez-Galindo C, Sorbara S, Magni C, Chiaravalli S, Casanova M, Cecchetto G, Godzinski J, Bien E, Stachowicz-Stencel T, Brennan B, Reguerre Y, Sultan I, Brecht IB. The challenge of very rare childhood cancers in developed and developing countries. Expert Opin Orphan Drugs 2017. [DOI: 10.1080/21678707.2017.1298440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | - Gianni Bisogno
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Daniel Orbach
- Department of Pediatrics, Adolescent and Young Adult Oncology, Institut Curie, Paris, France
| | | | - Veronica Giron
- National Pediatric Oncology Unit/Unidad Nacional de Oncologia Pediatrica, Guatemala City, Guatemala
| | | | - Silvia Sorbara
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Chiara Magni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Giovanni Cecchetto
- Pediatric Surgery, Department of Pediatrics, Padova University Hospital, Padova, Italy
| | - Jan Godzinski
- Department of Pediatric Surgery, Marciniak Hospital, Wroclaw, Poland
| | - Ewa Bien
- Department of Pediatrics, Medical University, Gdansk, Poland
| | | | - Bernadette Brennan
- Department of Pediatric Oncology, Royal Manchester Children’s Hospital, Manchester, UK
| | - Yves Reguerre
- Pediatric Hematology-Oncology Department, Centre Hospitalier Universitaire, Angers, France
| | - Iyad Sultan
- Department of Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Ines B. Brecht
- Pediatric Hematology and Oncology, University of Tuebingen, Tuebingen, Germany
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173
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Sparber-Sauer M, Seitz G, Kirsch S, Vokuhl C, Leuschner I, Dantonello TM, Scheer M, von Kalle T, Ljungman G, Bielack SS, Klingebiel T, Fuchs J, Koscielniak E. The impact of local control in the treatment of type II/III pleuropulmonary blastoma. Experience of the Cooperative Weichteilsarkom Studiengruppe (CWS). J Surg Oncol 2017; 115:164-172. [DOI: 10.1002/jso.24416] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/06/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Monika Sparber-Sauer
- Klinikum Stuttgart, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital; Pediatrics 5 (Pediatric Oncology, Hematology, Immunology); Stuttgart Germany
| | - Guido Seitz
- Department of Pediatric Surgery; University Childreńs Hospital; Marburg Germany
| | - Sylvia Kirsch
- Klinikum Stuttgart, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital; Pediatrics 5 (Pediatric Oncology, Hematology, Immunology); Stuttgart Germany
- Kinder- und Jugendarztpraxis Dr. Konstatopoulos; Munich Germany
| | | | - Ivo Leuschner
- Institute of Paidopathology; University of Kiel; Kiel Germany
| | - Tobias M. Dantonello
- Klinikum Stuttgart, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital; Pediatrics 5 (Pediatric Oncology, Hematology, Immunology); Stuttgart Germany
| | - Monika Scheer
- Klinikum Stuttgart, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital; Pediatrics 5 (Pediatric Oncology, Hematology, Immunology); Stuttgart Germany
| | - Thekla von Kalle
- Klinikum Stuttgart, Zentrum für Kinder-, Jugend- und Frauenmedizin; Olgahospital, Institute of Radiology; Stuttgart Germany
| | - Gustaf Ljungman
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - Stefan S. Bielack
- Klinikum Stuttgart, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital; Pediatrics 5 (Pediatric Oncology, Hematology, Immunology); Stuttgart Germany
- Department of Pediatric Hematology and Oncology; University of Muenster; Muenster Germany
| | - Thomas Klingebiel
- University of Frankfurt, Hospital for Children and Adolescents; Frankfurt/M. Germany
| | - Joerg Fuchs
- Department of Pediatric Surgery and Urology; University Childreńs Hospital; Tuebingen Germany
| | - Ewa Koscielniak
- Klinikum Stuttgart, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital; Pediatrics 5 (Pediatric Oncology, Hematology, Immunology); Stuttgart Germany
- Department of Pediatric Hematology and Oncology; University Childreńs Hospital; Tuebingen Germany
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174
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Lamas-Pinheiro R, David M, Henriques-Coelho T. Reply to the Letter to the Editor 'Type I Pleuropulmonary Blastoma versus Congenital Pulmonary Airway Malformation Type IV'. Neonatology 2017; 111:77-78. [PMID: 27577236 DOI: 10.1159/000447993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 06/28/2016] [Indexed: 11/19/2022]
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175
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Dehner LP, Messinger YH, Williams GM, Stewart DR, Harney LA, Schultz KA, Hill DA. Type I Pleuropulmonary Blastoma versus Congenital Pulmonary Airway Malformation Type IV. Neonatology 2017; 111:76. [PMID: 27562209 DOI: 10.1159/000447992] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 06/27/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Louis P Dehner
- Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St. Louis, Mo., USA
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176
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Winant AJ, Schooler GR, Concepcion NDP, Lee EY. Current Updates on Pediatric Pulmonary Infections. Semin Roentgenol 2017; 52:35-42. [DOI: 10.1053/j.ro.2016.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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177
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Liu DJ, Perrier R, Wei XC, Joseph JT, Strother D. Metachronous Type I pleuropulmonary blastoma and atypical choroid plexus papilloma in a young child. Pediatr Blood Cancer 2016; 63:2240-2242. [PMID: 27442759 DOI: 10.1002/pbc.26160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 06/21/2016] [Accepted: 06/26/2016] [Indexed: 11/11/2022]
Abstract
Pleuropulmonary blastoma (PPB) is a rare childhood tumor, often associated with germline DICER1 mutations and a risk for development of other benign and malignant tumors, a constellation termed DICER1 syndrome. A 1-year-old male was diagnosed with Type I PPB and screened regularly thereafter for detection of intrathoracic and intraabdominal disease. Ten months after diagnosis of PPB, he presented with headaches and vomiting. He was diagnosed with atypical choroid plexus papilloma, a lesion not previously reported with PPB. The presence of central nervous system symptoms in patients with PPB or a phenotype suggestive of DICER1 syndrome should prompt early intracranial imaging.
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Affiliation(s)
- David J Liu
- MD Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Renee Perrier
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Xing-Chang Wei
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jeffrey T Joseph
- Department of Pathology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Douglas Strother
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. .,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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178
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Abstract
Dr. Louis Dehner is an internationally renowned surgical pathologist who has published multiple textbooks and has authored or co-authored nearly 400 original articles in the medical literature. While many think of him as a pediatric pathologist, he has contributed to the literature across virtually the entire breadth of surgical pathology, and the lung and pleura is no exception. This review will highlight Dr. Dehner׳s contributions to the pulmonary and pleural pathology literature in the areas of infectious disease, medical lung disease and transplant pathology, and a number of neoplasms of the lung and pleura, with the remainder of this manuscript dedicated to the still evolving story of the pleuropulmonary blastoma as the signature contribution of his long and distinguished career.
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Affiliation(s)
- Jon H Ritter
- Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 South Euclid, St. Louis, Missouri.
| | - D Ashley Hill
- Department of Pathology, Children׳s National Medical Center, Washington, DC
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179
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Macrocephaly associated with the DICER1 syndrome. Genet Med 2016; 19:244-248. [PMID: 27441995 PMCID: PMC5253131 DOI: 10.1038/gim.2016.83] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/29/2016] [Indexed: 11/30/2022] Open
Abstract
Background Germline mutations in DICER1 increase the risk of various tumors, including pleuropulmonary blastoma. Macrocephaly and symmetric overgrowth has been reported in some, but not all, patients with mosaic DICER1 RNase IIIb mutations; the prevalence of these features in individuals with constitutional germline DICER1 mutations is unknown. Methods We analyzed prospectively collected auxology data from 67 DICER1 mutation carriers and 43 family controls. We assessed differences between groups using an exact test for proportions and generalized estimating equations for continuous dependent variables. Results Twenty-eight DICER1 mutation carriers (42%) were macrocephalic, and none had an occipital-frontal circumference (OFC) below the 3rd centile, which significantly differed from family controls, of whom five were macrocephalic (12%) and two had OFC below the 3rd centile (5%) (P<0.001). DICER1 mutation carriers were taller than familial controls after controlling for gender (P=0.048), but similar proportions of both groups were above the 97th centile of population norms. Head circumference remained increased after adjusting for differences in height. Conclusions For the first time, we establish macrocephaly as a common finding in the DICER1 syndrome. Like some of the other tumor-predisposition disorders, macrocephaly may be a useful, albeit a subtle, clinical clue to the DICER1 syndrome diagnosis.
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180
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Öztorun Cİ, Demir R, Karakuş E, Tuna CK, Bostancı SA, Şenaylı A, Azılı MN, Şenel E. WITHDRAWN: Multiseptate Gallbladder, a rare cause of recurrent abdominal pain: A case report and review of the literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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181
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Giuseppucci C, Reusmann A, Giubergia V, Barrias C, Krüger A, Siminovich M, Botto H, Cadario M, Boglione M, Strambach J, Barrenechea M. Primary lung tumors in children: 24 years of experience at a referral center. Pediatr Surg Int 2016; 32:451-7. [PMID: 26971789 DOI: 10.1007/s00383-016-3884-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Primary lung tumors are rare during childhood and encompass a wide variety of histological types. Each has a different biology and a different therapeutic approach. The aim of this article is to review the experience of a pediatric referral center with this kind of tumors during the last 24 years. METHODS A retrospective chart review was performed for patients with diagnosis of primary lung tumor between the years 1990-2014. The variables analyzed were age, sex, course of the disease, symptoms, localization, surgery, histology and outcome. RESULTS Between 1990 and 2014, 38 patients with primary lung tumors were treated at our institution. Age at presentation was 6.6 ± 5.2 years (r 0.91-16.58) and the female:male relationship was 1.37. Inflammatory myofibroblastic lung tumor (n = 13), carcinoid tumor (n = 6) and pleuropulmonary blastoma (n = 6) were the most frequent histological types. Persistent radiographic abnormality was the most frequent presenting sign (34 %). Global mortality was 15.8 % varying according to histology. CONCLUSION Although the diagnosis of primary lung tumor is rare, the persistence of a radiographic abnormality in spite of adequate treatment for inflammatory processes forces us to evaluate further. The age of the patient is an important factor in the decision of the diagnostic work-up.
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Affiliation(s)
- Carlos Giuseppucci
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina.
| | - Aixa Reusmann
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Verónica Giubergia
- Department of Pulmonology, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Carolina Barrias
- Department of Pulmonology, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Anahi Krüger
- Department of Pulmonology, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Mónica Siminovich
- Department of Pathology, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Hugo Botto
- Department of Endoscopy, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Martin Cadario
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Mariano Boglione
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Julieta Strambach
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Marcelo Barrenechea
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
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182
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Can congenital pulmonary airway malformation be distinguished from Type I pleuropulmonary blastoma based on clinical and radiological features? J Pediatr Surg 2016; 51:33-7. [PMID: 26561249 PMCID: PMC5031236 DOI: 10.1016/j.jpedsurg.2015.10.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 10/06/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND The management of congenital cystic lung lesions is controversial. Arguments for routine resection during infancy include the possibility of the lesion being Type I pleuropulmonary blastoma (PPB) rather than a cystic congenital pulmonary airway malformation (CPAM). We aimed to identify clinical and radiological features that might distinguish between CPAM and PPB and to develop a diagnostic algorithm based on these features. METHODS All recorded cases of Type I PPB were retrieved from the International PPB Registry and compared with an institutional cohort of children undergoing resection of CPAM (2002-2013) that was noted at some stage to be at least partially cystic. Regression models were created to identify variables that might differentiate CPAM from PPB. Odds ratio (OR) and positive predictive value (PPV) were calculated for each variable and a decision algorithm developed. RESULTS In 112 cases of Type I PPB and 103 of CPAM, factors favoring a diagnosis of CPAM included prenatal detection (OR 89.4), systemic feeding vessel (OR 61.7), asymptomatic (OR 8.0), and hyperinflated lung (OR 6.6). Factors favoring a diagnosis of PPB included bilateral or multisegment involvement (OR 2.4). A decision algorithm that helps to identify lesions requiring resection and those which can be safely observed is presented. CONCLUSION Clinical and radiological features can help to differentiate between CPAM and PPB. Our algorithm allows identification of children at higher risk of PPB in whom we would recommend resection and those at low risk in whom continued close observation is safe.
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183
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Boucherat O, Landry-Truchon K, Bérubé-Simard FA, Houde N, Beuret L, Lezmi G, Foulkes WD, Delacourt C, Charron J, Jeannotte L. Epithelial inactivation of Yy1 abrogates lung branching morphogenesis. Development 2015; 142:2981-95. [PMID: 26329601 DOI: 10.1242/dev.120469] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Yin Yang 1 (YY1) is a multifunctional zinc-finger-containing transcription factor that plays crucial roles in numerous biological processes by selectively activating or repressing transcription, depending upon promoter contextual differences and specific protein interactions. In mice, Yy1 null mutants die early in gestation whereas Yy1 hypomorphs die at birth from lung defects. We studied how the epithelial-specific inactivation of Yy1 impacts on lung development. The Yy1 mutation in lung epithelium resulted in neonatal death due to respiratory failure. It impaired tracheal cartilage formation, altered cell differentiation, abrogated lung branching and caused airway dilation similar to that seen in human congenital cystic lung diseases. The cystic lung phenotype in Yy1 mutants can be partly explained by the reduced expression of Shh, a transcriptional target of YY1, in lung endoderm, and the subsequent derepression of mesenchymal Fgf10 expression. Accordingly, SHH supplementation partially rescued the lung phenotype in vitro. Analysis of human lung tissues revealed decreased YY1 expression in children with pleuropulmonary blastoma (PPB), a rare pediatric lung tumor arising during fetal development and associated with DICER1 mutations. No evidence for a potential genetic interplay between murine Dicer and Yy1 genes during lung morphogenesis was observed. However, the cystic lung phenotype resulting from the epithelial inactivation of Dicer function mimics the Yy1 lung malformations with similar changes in Shh and Fgf10 expression. Together, our data demonstrate the crucial requirement for YY1 in lung morphogenesis and identify Yy1 mutant mice as a potential model for studying the genetic basis of PPB.
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Affiliation(s)
- Olivier Boucherat
- Centre de Recherche sur le Cancer de l'Université Laval; CRCHUQ, L'Hôtel-Dieu de Québec, Québec, G1R 3S3, Canada
| | - Kim Landry-Truchon
- Centre de Recherche sur le Cancer de l'Université Laval; CRCHUQ, L'Hôtel-Dieu de Québec, Québec, G1R 3S3, Canada
| | - Félix-Antoine Bérubé-Simard
- Centre de Recherche sur le Cancer de l'Université Laval; CRCHUQ, L'Hôtel-Dieu de Québec, Québec, G1R 3S3, Canada
| | - Nicolas Houde
- Centre de Recherche sur le Cancer de l'Université Laval; CRCHUQ, L'Hôtel-Dieu de Québec, Québec, G1R 3S3, Canada
| | - Laurent Beuret
- Centre de Recherche sur le Cancer de l'Université Laval; CRCHUQ, L'Hôtel-Dieu de Québec, Québec, G1R 3S3, Canada
| | - Guillaume Lezmi
- AP-HP, Hôpital Necker-Enfants Malades, Service de Pneumologie Pédiatrique, Université Paris-Descartes, Paris, 75015, France Inserm U955, IMRB, Equipe 04, Créteil, 94011, France
| | - William D Foulkes
- Department of Medical Genetics, Lady Davis Institute and Segal Cancer Centre, Jewish General Hospital, Montréal, H3G 1A4, Canada
| | - Christophe Delacourt
- AP-HP, Hôpital Necker-Enfants Malades, Service de Pneumologie Pédiatrique, Université Paris-Descartes, Paris, 75015, France Inserm U955, IMRB, Equipe 04, Créteil, 94011, France
| | - Jean Charron
- Centre de Recherche sur le Cancer de l'Université Laval; CRCHUQ, L'Hôtel-Dieu de Québec, Québec, G1R 3S3, Canada
| | - Lucie Jeannotte
- Centre de Recherche sur le Cancer de l'Université Laval; CRCHUQ, L'Hôtel-Dieu de Québec, Québec, G1R 3S3, Canada
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184
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Pappo AS, Furman WL, Schultz KA, Ferrari A, Helman L, Krailo MD. Rare Tumors in Children: Progress Through Collaboration. J Clin Oncol 2015; 33:3047-54. [PMID: 26304909 DOI: 10.1200/jco.2014.59.3632] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rare pediatric tumors account for approximately 10% of all childhood cancers, which in themselves are a rare entity. The diverse histologies and clinical behaviors of rare pediatric tumors pose challenges to the investigation of their biologic and clinical features. National and international cooperative groups such as the Rare Tumor Committee of the Children's Oncology Group, Rare Tumors in Pediatric Age Project, and European Cooperative Study Group for Pediatric Rare Tumors have developed several initiatives to advance knowledge about rare pediatric cancers. However, these programs have been only partially effective, necessitating the development of alternative mechanisms to study these challenging diseases. In this article, we review the current national and international collaborative strategies to study rare pediatric cancers and alternative methods under exploration to enhance those efforts, such as independent registries and disease-specific, National Cancer Institute-sponsored clinics.
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Affiliation(s)
- Alberto S Pappo
- Alberto S. Pappo and Wayne L. Furman, St Jude Children's Research Hospital, Memphis, TN; Kris A. Schultz, Children's Hospital of Minnesota, Minneapolis, MN; Andrea Ferrari, Instituto Nazionale Tumori, Milano, Italy; Lee Helman, National Cancer Institute Center for Cancer Research, Bethesda, MD; and Mark D. Krailo, Keck School of Medicine, Los Angeles, CA.
| | - Wayne L Furman
- Alberto S. Pappo and Wayne L. Furman, St Jude Children's Research Hospital, Memphis, TN; Kris A. Schultz, Children's Hospital of Minnesota, Minneapolis, MN; Andrea Ferrari, Instituto Nazionale Tumori, Milano, Italy; Lee Helman, National Cancer Institute Center for Cancer Research, Bethesda, MD; and Mark D. Krailo, Keck School of Medicine, Los Angeles, CA
| | - Kris A Schultz
- Alberto S. Pappo and Wayne L. Furman, St Jude Children's Research Hospital, Memphis, TN; Kris A. Schultz, Children's Hospital of Minnesota, Minneapolis, MN; Andrea Ferrari, Instituto Nazionale Tumori, Milano, Italy; Lee Helman, National Cancer Institute Center for Cancer Research, Bethesda, MD; and Mark D. Krailo, Keck School of Medicine, Los Angeles, CA
| | - Andrea Ferrari
- Alberto S. Pappo and Wayne L. Furman, St Jude Children's Research Hospital, Memphis, TN; Kris A. Schultz, Children's Hospital of Minnesota, Minneapolis, MN; Andrea Ferrari, Instituto Nazionale Tumori, Milano, Italy; Lee Helman, National Cancer Institute Center for Cancer Research, Bethesda, MD; and Mark D. Krailo, Keck School of Medicine, Los Angeles, CA
| | - Lee Helman
- Alberto S. Pappo and Wayne L. Furman, St Jude Children's Research Hospital, Memphis, TN; Kris A. Schultz, Children's Hospital of Minnesota, Minneapolis, MN; Andrea Ferrari, Instituto Nazionale Tumori, Milano, Italy; Lee Helman, National Cancer Institute Center for Cancer Research, Bethesda, MD; and Mark D. Krailo, Keck School of Medicine, Los Angeles, CA
| | - Mark D Krailo
- Alberto S. Pappo and Wayne L. Furman, St Jude Children's Research Hospital, Memphis, TN; Kris A. Schultz, Children's Hospital of Minnesota, Minneapolis, MN; Andrea Ferrari, Instituto Nazionale Tumori, Milano, Italy; Lee Helman, National Cancer Institute Center for Cancer Research, Bethesda, MD; and Mark D. Krailo, Keck School of Medicine, Los Angeles, CA
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185
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Abstract
The remit of this article is principally to explore the risk of malignancy developing in a congenital cystic adenomatoid malformation (CCAM) in adulthood.
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186
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Insulin-like Growth Factor 2 Gene Expression Molecularly Differentiates Pleuropulmonary Blastoma and Embryonal Rhabdomyosarcoma. J Pediatr Hematol Oncol 2015; 37:e356-60. [PMID: 26056800 PMCID: PMC4506202 DOI: 10.1097/mph.0000000000000382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The sarcomatous element in pleuropulmonary blastoma (PPB) is often histologically indistinguishable from embryonal rhabdomyosarcoma (ERMS). A diagnosis of PPB is often made after definitive surgical resection based on pathologic features, most notably the presence of hamartomatous pulmonary elements. Samples from seven PPB patients were obtained from the rhabdomyosarcomatous portion of the tumor by macrodissection. Representative ERMS tumor tissue was selected from 21 ERMS patient samples. Formalin-fixed paraffin-embedded tissue scrolls from each sample were analyzed using the Affymetrix Human Exon arrays. All PPB patients and 7 of 21 ERMS patients were 3 years old and younger. Twenty transcripts (10 annotated, 10 noncoding RNAs) were significantly differentially expressed in ERMS when compared with PPB samples. Insulin-like growth factor 2 (IGF2) was uniformly overexpressed in ERMS (19/21>400) but was expressed at low levels in PPB (P<0.001). Two ERMS cases that had low level IGF2 expression were 3 years and younger of age. No other differences between the 2 approached this degree of significance, despite a common rhabdomyogenic phenotype in the sarcomatous areas of PPB. PPB, unlike most ERMS, appears not to be driven by autocrine IGF2 signaling.
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187
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Brenneman M, Field A, Yang J, Williams G, Doros L, Rossi C, Schultz KA, Rosenberg A, Ivanovich J, Turner J, Gordish-Dressman H, Stewart D, Yu W, Harris A, Schoettler P, Goodfellow P, Dehner L, Messinger Y, Hill DA. Temporal order of RNase IIIb and loss-of-function mutations during development determines phenotype in pleuropulmonary blastoma / DICER1 syndrome: a unique variant of the two-hit tumor suppression model. F1000Res 2015; 4:214. [PMID: 26925222 PMCID: PMC4712775 DOI: 10.12688/f1000research.6746.2] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 01/27/2023] Open
Abstract
Pleuropulmonary blastoma (PPB) is the most frequent pediatric lung tumor and often the first indication of a pleiotropic cancer predisposition,
DICER1 syndrome, comprising a range of other individually rare, benign and malignant tumors of childhood and early adulthood. The genetics of
DICER1-associated tumorigenesis are unusual in that tumors typically bear neomorphic missense mutations at one of five specific “hotspot” codons within the RNase IIIb domain of
DICER 1, combined with complete loss of function (LOF) in the other allele. We analyzed a cohort of 124 PPB children for predisposing
DICER1 mutations and sought correlations with clinical phenotypes. Over 70% have inherited or
de novo germline LOF mutations, most of which truncate the
DICER1 open reading frame. We identified a minority of patients who have no germline mutation, but are instead mosaic for predisposing
DICER1 mutations. Mosaicism for RNase IIIb domain hotspot mutations defines a special category of
DICER1 syndrome patients, clinically distinguished from those with germline or mosaic LOF mutations by earlier onsets and numerous discrete foci of neoplastic disease involving multiple syndromic organ sites. A final category of PBB patients lack predisposing germline or mosaic mutations and have sporadic (rather than syndromic) disease limited to a single PPB tumor bearing tumor-specific RNase IIIb and LOF mutations. We propose that acquisition of a neomorphic RNase IIIb domain mutation is the rate limiting event in
DICER1-associated
tumorigenesis, and that distinct clinical phenotypes associated with mutational categories reflect the temporal order in which LOF and RNase IIIb domain mutations are acquired during development.
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Affiliation(s)
- Mark Brenneman
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Amanda Field
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Jiandong Yang
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Gretchen Williams
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Leslie Doros
- Division of Oncology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Christopher Rossi
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Kris Ann Schultz
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Avi Rosenberg
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Jennifer Ivanovich
- Department of Surgery, Washington University Medical Center, St. Louis, MO, 63110, USA
| | - Joyce Turner
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Division of Genetics, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Heather Gordish-Dressman
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Department of Integrative Systems Biology, George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Douglas Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, 20892, USA
| | - Weiying Yu
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Division of Oncology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Anne Harris
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Peter Schoettler
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Paul Goodfellow
- College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Louis Dehner
- Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St. Louis, MO, 63110, USA
| | - Yoav Messinger
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - D Ashley Hill
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Integrative Systems Biology, George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
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188
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Brenneman M, Field A, Yang J, Williams G, Doros L, Rossi C, Schultz KA, Rosenberg A, Ivanovich J, Turner J, Gordish-Dressman H, Stewart D, Yu W, Harris A, Schoettler P, Goodfellow P, Dehner L, Messinger Y, Hill DA. Temporal order of RNase IIIb and loss-of-function mutations during development determines phenotype in pleuropulmonary blastoma / DICER1 syndrome: a unique variant of the two-hit tumor suppression model. F1000Res 2015; 4:214. [PMID: 26925222 DOI: 10.12688/f1000research.6746.1] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 01/05/2023] Open
Abstract
Pleuropulmonary blastoma (PPB) is the most frequent pediatric lung tumor and often the first indication of a pleiotropic cancer predisposition, DICER1 syndrome, comprising a range of other individually rare, benign and malignant tumors of childhood and early adulthood. The genetics of DICER1-associated tumorigenesis are unusual in that tumors typically bear neomorphic missense mutations at one of five specific "hotspot" codons within the RNase IIIb domain of DICER 1, combined with complete loss of function (LOF) in the other allele. We analyzed a cohort of 124 PPB children for predisposing DICER1 mutations and sought correlations with clinical phenotypes. Over 70% have inherited or de novo germline LOF mutations, most of which truncate the DICER1 open reading frame. We identified a minority of patients who have no germline mutation, but are instead mosaic for predisposing DICER1 mutations. Mosaicism for RNase IIIb domain hotspot mutations defines a special category of DICER1 syndrome patients, clinically distinguished from those with germline or mosaic LOF mutations by earlier onsets and numerous discrete foci of neoplastic disease involving multiple syndromic organ sites. A final category of PBB patients lack predisposing germline or mosaic mutations and have sporadic (rather than syndromic) disease limited to a single PPB tumor bearing tumor-specific RNase IIIb and LOF mutations. We propose that acquisition of a neomorphic RNase IIIb domain mutation is the rate limiting event in DICER1-associated tumorigenesis, and that distinct clinical phenotypes associated with mutational categories reflect the temporal order in which LOF and RNase IIIb domain mutations are acquired during development.
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Affiliation(s)
- Mark Brenneman
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Amanda Field
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Jiandong Yang
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Gretchen Williams
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Leslie Doros
- Division of Oncology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Christopher Rossi
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Kris Ann Schultz
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Avi Rosenberg
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Jennifer Ivanovich
- Department of Surgery, Washington University Medical Center, St. Louis, MO, 63110, USA
| | - Joyce Turner
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Division of Genetics, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Heather Gordish-Dressman
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Department of Integrative Systems Biology, George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Douglas Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, 20892, USA
| | - Weiying Yu
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Division of Oncology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Anne Harris
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Peter Schoettler
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Paul Goodfellow
- College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Louis Dehner
- Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St. Louis, MO, 63110, USA
| | - Yoav Messinger
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - D Ashley Hill
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Integrative Systems Biology, George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
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189
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Zucker EJ, Epelman M, Newman B. Perinatal Thoracic Mass Lesions: Pre- and Postnatal Imaging. Semin Ultrasound CT MR 2015; 36:501-21. [PMID: 26614133 DOI: 10.1053/j.sult.2015.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Chest masses present a common problem in the perinatal period. Advances in prenatal ultrasound, supplemented by fetal magnetic resonance imaging, now allow early detection and detailed characterization of many thoracic lesions in utero. As such, in asymptomatic infants, assessment with postnatal computed tomography or magnetic resonance imaging can often be delayed for several months until the time at which surgery is being contemplated. Bronchopulmonary malformations comprise most of the thoracic masses encountered in clinical practice. However, a variety of other pathologies can mimic their appearances or produce similar effects such as hypoplasia of a lung or both lungs. Understanding of the key differentiating clinical and imaging features can assist in optimizing prognostication and timely management.
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Affiliation(s)
- Evan J Zucker
- Department of Radiology, Stanford University School of Medicine, Lucile Packard Children's Hospital, Stanford, CA.
| | - Monica Epelman
- Department of Medical Imaging, Nemours Children's Hospital, Orlando, FL
| | - Beverley Newman
- Department of Radiology, Stanford University School of Medicine, Lucile Packard Children's Hospital, Stanford, CA
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190
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Yin Y, Castro AM, Hoekstra M, Yan TJ, Kanakamedala AC, Dehner LP, Hill DA, Ornitz DM. Fibroblast Growth Factor 9 Regulation by MicroRNAs Controls Lung Development and Links DICER1 Loss to the Pathogenesis of Pleuropulmonary Blastoma. PLoS Genet 2015; 11:e1005242. [PMID: 25978641 PMCID: PMC4433140 DOI: 10.1371/journal.pgen.1005242] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/26/2015] [Indexed: 11/19/2022] Open
Abstract
Pleuropulmonary Blastoma (PPB) is the primary neoplastic manifestation of a pediatric cancer predisposition syndrome that is associated with several diseases including cystic nephroma, Wilms tumor, neuroblastoma, rhabdomyosarcoma, medulloblastoma, and ovarian Sertoli-Leydig cell tumor. The primary pathology of PPB, epithelial cysts with stromal hyperplasia and risk for progression to a complex primitive sarcoma, is associated with familial heterozygosity and lesion-associated epithelial loss-of-heterozygosity of DICER1. It has been hypothesized that loss of heterozygosity of DICER1 in lung epithelium is a non-cell autonomous etiology of PPB and a critical pathway that regulates lung development; however, there are no known direct targets of epithelial microRNAs (miRNAs) in the lung. Fibroblast Growth Factor 9 (FGF9) is expressed in the mesothelium and epithelium during lung development and primarily functions to regulate lung mesenchyme; however, there are no known mechanisms that regulate FGF9 expression during lung development. Using mouse genetics and molecular phenotyping of human PPB tissue, we show that FGF9 is overexpressed in lung epithelium in the initial multicystic stage of Type I PPB and that in mice lacking epithelial Dicer1, or induced to overexpress epithelial Fgf9, increased Fgf9 expression results in pulmonary mesenchymal hyperplasia and a multicystic architecture that is histologically and molecularly indistinguishable from Type I PPB. We further show that miR-140 is expressed in lung epithelium, regulates epithelial Fgf9 expression, and regulates pseudoglandular stages of lung development. These studies identify an essential miRNA-FGF9 pathway for lung development and a non-cell autonomous signaling mechanism that contributes to the mesenchymal hyperplasia that is characteristic of Type I PPB.
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Affiliation(s)
- Yongjun Yin
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Angela M. Castro
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Marrit Hoekstra
- Department of Pathology, Children’s National Medical Center, Washington, D.C., United States of America
| | - Thomas J. Yan
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Ajay C. Kanakamedala
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Louis P. Dehner
- Lauren V. Ackerman Division of Surgical Pathology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - D. Ashley Hill
- Lauren V. Ackerman Division of Surgical Pathology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail: (DAH); (DMO)
| | - David M. Ornitz
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail: (DAH); (DMO)
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191
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The Role of Registries and Tumor Banking in Rare Pediatric Tumors. CURRENT PEDIATRICS REPORTS 2015. [DOI: 10.1007/s40124-015-0077-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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192
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Kotecha RS, Kees UR, Cole CH, Gottardo NG. Rare childhood cancers--an increasing entity requiring the need for global consensus and collaboration. Cancer Med 2015; 4:819-24. [PMID: 25664881 PMCID: PMC4472204 DOI: 10.1002/cam4.426] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/30/2014] [Accepted: 01/05/2015] [Indexed: 01/19/2023] Open
Abstract
Rare childhood cancers have not benefited to the same extent from the gains that have been made for their frequently occurring counterparts. In recent years, this gap has been recognized and a number of vehicles now exist to improve outcome, including rare tumor groups, disease-specific registries, and clinics. The multitude of approaches has allowed significant progress, however, this framework is limited by patient number and is not inclusive for every type of rare childhood cancer. These shortcomings can be overcome by a single global unified approach to the study of rare childhood tumors.
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Affiliation(s)
- Rishi S Kotecha
- Department of Haematology and Oncology, Princess Margaret Hospital for Children, GPO Box D184, Perth, Western Australia, 6840, Australia.,School of Paediatrics and Child Health, University of Western Australia, GPO Box D184, Perth, Western Australia, 6840, Australia.,Telethon Kids Institute, University of Western Australia, PO Box 855, Perth, Western Australia, 6872, Australia
| | - Ursula R Kees
- Telethon Kids Institute, University of Western Australia, PO Box 855, Perth, Western Australia, 6872, Australia
| | - Catherine H Cole
- Department of Haematology and Oncology, Princess Margaret Hospital for Children, GPO Box D184, Perth, Western Australia, 6840, Australia.,School of Paediatrics and Child Health, University of Western Australia, GPO Box D184, Perth, Western Australia, 6840, Australia
| | - Nicholas G Gottardo
- Department of Haematology and Oncology, Princess Margaret Hospital for Children, GPO Box D184, Perth, Western Australia, 6840, Australia.,School of Paediatrics and Child Health, University of Western Australia, GPO Box D184, Perth, Western Australia, 6840, Australia.,Telethon Kids Institute, University of Western Australia, PO Box 855, Perth, Western Australia, 6872, Australia
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193
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Dehner LP, Messinger YH, Schultz KAP, Williams GM, Wikenheiser-Brokamp K, Hill DA. Pleuropulmonary Blastoma: Evolution of an Entity as an Entry into a Familial Tumor Predisposition Syndrome. Pediatr Dev Pathol 2015; 18:504-11. [PMID: 26698637 PMCID: PMC9743680 DOI: 10.2350/15-10-1732-oa.1] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Pleuropulmonary blastoma (PPB) is the most common primary malignant neoplasm of the lung in children. Like other solid dysontogenic neoplasms, this tumor typically presents before 7 years of age. The earliest manifestation is the presence of a lung cyst(s), which is usually recognized in the first year of life and is difficult to differentiate on the basis of imaging studies from non-neoplastic cysts of early childhood. From a multilocular cyst, PPB has the potential to progress to a high-grade multipatterned primitive sarcoma. More than 65% of all affected children have a heterozygous germline mutation in DICER1. The DICER1 PPB familial tumor predisposition syndrome is initially recognized in most cases on the basis of PPB alone but also by several other unique and characteristic extrapulmonary tumors, including pediatric cystic nephroma, nasal chondromesenchymal hamartoma, nodular lesions of the thyroid, embryonal rhabdomyosarcoma of the cervix, and ciliary body medulloepithelioma.
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Affiliation(s)
- Louis P. Dehner
- International Pleuropulmonary Blastoma Registry. Children’s Hospital and Clinics of Minnesota, Minneapolis, Minnesota;,Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish and St. Louis Children’s Hospitals, Washington University Medical Center, St. Louis, Missouri
| | - Yoav H. Messinger
- International Pleuropulmonary Blastoma Registry. Children’s Hospital and Clinics of Minnesota, Minneapolis, Minnesota
| | - Kris Ann P. Schultz
- International Pleuropulmonary Blastoma Registry. Children’s Hospital and Clinics of Minnesota, Minneapolis, Minnesota
| | - Gretchen M. Williams
- International Pleuropulmonary Blastoma Registry. Children’s Hospital and Clinics of Minnesota, Minneapolis, Minnesota
| | - Kathryn Wikenheiser-Brokamp
- International Pleuropulmonary Blastoma Registry. Children’s Hospital and Clinics of Minnesota, Minneapolis, Minnesota;,Division of Pathology and Pulmonary Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, and Department of Pathology, University of Cincinnati College of Medicine
| | - D. Ashley Hill
- International Pleuropulmonary Blastoma Registry. Children’s Hospital and Clinics of Minnesota, Minneapolis, Minnesota;,Division of Pathology, Children’s National Medical Center, Washington, District of Columbia
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