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Dong X, Png NCY, Fortier MV, Lim JY, Wong KPL, Choo JTL, Tan EC, Jamuar SS. Fibrous dysplasia in cardio-facio-cutaneous syndrome: A case report and review of literature. Am J Med Genet A 2022; 188:2732-2737. [PMID: 35801299 DOI: 10.1002/ajmg.a.62879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/16/2022] [Accepted: 05/30/2022] [Indexed: 01/25/2023]
Abstract
Cardio-facio-cutaneous (CFC) syndrome (OMIM #:115150, 615278, 615279, 615280) is a rare genetic condition caused by variants in the RAS/mitogen-activated protein kinase (MAPK) signal transduction pathway. Up to 75% of cases are caused by mutations in the BRAF gene, whereas KRAS gene mutation has only been reported in <2% of cases. CFC syndrome is characterized by cardiac abnormalities, distinctive craniofacial dysmorphism, and various cutaneous abnormalities. Musculoskeletal and orthopedic manifestations are also prevalent in patients with CFC syndrome, among which the most common are skeletal deformities and joint laxities. Dysplastic bone disorders, on the other hand, have not been reported in CFC syndrome before. We report on a case of symmetrical polyostotic fibrous dysplasia (FD) in a patient with CFC syndrome with the KRAS(NM_004985.5):c.57G>C; p.Leu19Phe variant. The FDs were incidentally picked up, and patient was conservatively managed and remained asymptomatic on follow-up. The same variant was reported previously in a patient with Oculoectodermal Syndrome (OES), who developed polyostotic non-ossifying fibroma (NOF). This case explores FD as a possible new clinical feature of CFC syndrome, and when linked to the historical case of OES, explores whether the KRAS(NM_004985.5):c.57G>C; p.Leu19Phe mutation may potentially contribute to the development of dysplastic bone lesions in patients with this particular mutation.
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Affiliation(s)
- Xiaoao Dong
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore
| | - Nicholas C Y Png
- Department of Diagnostic and Interventional Radiology, KK Women's and Children's Hospital, Singapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Radiology, KK Women's and Children's Hospital, Singapore
| | - Jiin Ying Lim
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,SingHealth Duke-NUS Genomic Medicine Centre, Singapore
| | - Kenneth P L Wong
- Department of Paediatric Orthopaedics, KK Women's and Children's Hospital, Singapore
| | - Jonathan T L Choo
- Department of Cardiology, KK Women's and Children's Hospital, Singapore
| | - Ene Choo Tan
- KK Research Centre, KK Women's and Children's Hospital, Singapore
| | - Saumya Shekhar Jamuar
- Department of Paediatrics, KK Women's and Children's Hospital, Singapore.,Department of Diagnostic and Interventional Radiology, KK Women's and Children's Hospital, Singapore
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2
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Beyens A, Dequeker L, Brems H, Janssens S, Syryn H, D’Hooghe A, De Paepe P, Vanwalleghem L, Stockman A, Vankwikelberge E, De Schepper S, Goeteyn M, Delbeke P, Callewaert B. Identification of Codon 146 KRAS Variants in Isolated Epidermal Nevus and Multiple Lesions in Oculoectodermal Syndrome: Confirmation of the Phenotypic Continuum of Mosaic RASopathies. Int J Mol Sci 2022; 23:ijms23074036. [PMID: 35409398 PMCID: PMC8999796 DOI: 10.3390/ijms23074036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 01/31/2023] Open
Abstract
Mosaic RASopathies are a molecularly heterogeneous group of (neuro)cutaneous syndromes with high phenotypical variability. Postzygotic variants in KRAS have been described in oculoectodermal syndrome (OES), encephalocraniocutaneous lipomatosis (ECCL) and epidermal nevus syndrome (ENS). This study confirms the continuum of mosaic neurocutaneous RASopathies showing codon 146 KRAS variants in an individual with OES and, for the first time, in an individual with (isolated) epidermal nevus. The presence of a nevus psiloliparus in individuals with OES indicates that this finding is not specific for ECCL and highlights the phenotypical overlap between ECCL and OES. The presence of the somatic KRAS variant in the nevus psiloliparus resolves the underlying molecular etiology of this fatty-tissue nevus. In addition, this finding refutes the theory of non-allelic twin-spotting as an underlying hypothesis to explain the concurrent presence of two different mosaicisms in one individual. The identification of codon 146 KRAS variants in isolated epidermal nevus introduces a new hot spot for this condition, which is useful for increasing molecular genetic testing using targeted gene sequencing panels.
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Affiliation(s)
- Aude Beyens
- Center for Medical Genetics Ghent, Ghent University Hospital, 9000 Ghent, Belgium; (A.B.); (S.J.); (H.S.)
- Department of Biomolecular Medicine, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (E.V.); (S.D.S.)
| | - Laure Dequeker
- Department of Ophthalmology, General Hospital Sint-Jan Brugge-Oostende, 8000 Bruges, Belgium; (L.D.); (P.D.)
- Department of Ophthalmology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Hilde Brems
- Department of Human Genetics, University Hospital Leuven, 3000 Leuven, Belgium;
| | - Sandra Janssens
- Center for Medical Genetics Ghent, Ghent University Hospital, 9000 Ghent, Belgium; (A.B.); (S.J.); (H.S.)
- Department of Biomolecular Medicine, Ghent University Hospital, 9000 Ghent, Belgium
| | - Hannes Syryn
- Center for Medical Genetics Ghent, Ghent University Hospital, 9000 Ghent, Belgium; (A.B.); (S.J.); (H.S.)
- Department of Biomolecular Medicine, Ghent University Hospital, 9000 Ghent, Belgium
| | - Anne D’Hooghe
- Department of Pediatrics, General Hospital Sint-Jan Brugge-Oostende, 8000 Bruges, Belgium
| | - Pascale De Paepe
- Department of Pathology, General Hospital Sint-Jan Brugge-Oostende, 8000 Bruges, Belgium; (P.D.P.); (L.V.)
| | - Lieve Vanwalleghem
- Department of Pathology, General Hospital Sint-Jan Brugge-Oostende, 8000 Bruges, Belgium; (P.D.P.); (L.V.)
| | - Annelies Stockman
- Department of Dermatology, General Hospital Delta Roeselare-Menen-Torhout, 8820 Torhout, Belgium;
| | - Elena Vankwikelberge
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (E.V.); (S.D.S.)
| | - Sofie De Schepper
- Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium; (E.V.); (S.D.S.)
| | - Marleen Goeteyn
- Department of Dermatology, General Hospital Sint-Jan Brugge-Oostende, 8000 Bruges, Belgium;
| | - Patricia Delbeke
- Department of Ophthalmology, General Hospital Sint-Jan Brugge-Oostende, 8000 Bruges, Belgium; (L.D.); (P.D.)
| | - Bert Callewaert
- Center for Medical Genetics Ghent, Ghent University Hospital, 9000 Ghent, Belgium; (A.B.); (S.J.); (H.S.)
- Department of Biomolecular Medicine, Ghent University Hospital, 9000 Ghent, Belgium
- Correspondence:
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3
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Kapoor S, Scanga HL, Reyes-Múgica M, Nischal KK. Somatic KRAS mutation affecting codon 146 in linear sebaceous nevus syndrome. Am J Med Genet A 2021; 185:3825-3830. [PMID: 34254724 DOI: 10.1002/ajmg.a.62422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/04/2021] [Accepted: 06/11/2021] [Indexed: 01/04/2023]
Abstract
Linear Sebaceous Nevus Syndrome is a rare disorder that presents with nevus sebaceus in association with corneal dermoids, colobomas, choroidal osteomas, and arachnoid cysts. It is thought to represent a mosaic RASopathy. These are disorders characterized by postzygotic somatic mutation in genes involved in RAS/MAPK signaling pathway. In this report we describe two patients with linear sebaceous nevus syndrome found to have mutations in codon 146 of KRAS with evidence of mosaicism. This specific mutation has previously been reported in Oculoectodermal Syndrome and Encephalocraniocutaneous Lipomatosis, two other mosaic RASopathies with predominantly cerebrooculocutaneous manifestations. These findings suggest that, while initially classified as different syndromes, these disorders should be evaluated and managed as a spectrum of related disorders.
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Affiliation(s)
- Saloni Kapoor
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Hannah L Scanga
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Ken K Nischal
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Chacon‐Camacho OF, Lopez‐Moreno D, Morales‐Sanchez MA, Hofmann E, Pacheco‐Quito M, Wieland I, Cortes‐Gonzalez V, Villanueva‐Mendoza C, Zenker M, Zenteno JC. Expansion of the phenotypic spectrum and description of molecular findings in a cohort of patients with oculocutaneous mosaic RASopathies. Mol Genet Genomic Med 2019; 7:e625. [PMID: 30891959 PMCID: PMC6503218 DOI: 10.1002/mgg3.625] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/08/2019] [Accepted: 02/11/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Postzygotic KRAS, HRAS, NRAS, and FGFR1 mutations result in a group of mosaic RASopathies characterized by related developmental anomalies in eye, skin, heart, and brain. These oculocutaneous disorders include oculoectodermal syndrome (OES) encephalo-cranio-cutaneous lipomatosis (ECCL), and Schimmelpenning-Feuerstein-Mims syndrome (SFMS). Here, we report the results of the clinical and molecular characterization of a novel cohort of patients with oculocutaneous mosaic RASopathies. METHODS Two OES, two ECCL, and two SFMS patients were ascertained in the study. In addition, two subjects with unilateral isolated epibulbar dermoids were also enrolled. Molecular analysis included PCR amplification and Sanger sequencing of KRAS, HRAS, NRAS, and FGFR1 genes in DNA obtained from biopsies (skin/epibulbar dermoids), buccal mucosa, and blood leukocytes. Massive parallel sequencing was employed in two cases with low-level mosaicism. RESULTS In DNA from biopsies, mosaicism for pathogenic variants, including KRAS p.Ala146Thr in two OES subjects, FGFR1 p.Asn546Lys and KRAS p.Ala146Val in ECCL patients, and KRAS p.Gly12Asp in both SFMS patients, was demonstrated. No mutations were shown in DNA from conjunctival lesions in two subjects with isolated epibubar dermoids. CONCLUSION Our study allowed the expansion of the clinical spectrum of mosaic RASopathies and supports that mosaicism for recurrent mutations in KRAS and FGFR1 is a commonly involved mechanism in these rare oculocutaneous anomalies.
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Affiliation(s)
| | - Daniel Lopez‐Moreno
- Department of GeneticsInstitute of Ophthalmology “Conde de Valenciana”Mexico CityMexico
| | | | - Enriqueta Hofmann
- Department of GlaucomaInstitute of Ophthalmology “Conde de Valenciana”Mexico CityMexico
| | | | - Ilse Wieland
- Institute of Human Genetics, University HospitalMagdeburgGermany
| | - Vianney Cortes‐Gonzalez
- Department of GeneticsHospital "Dr. Luis Sanchez Bulnes", Asociación para Evitar la Ceguera en MéxicoMexico CityMexico
| | - Cristina Villanueva‐Mendoza
- Department of GeneticsHospital "Dr. Luis Sanchez Bulnes", Asociación para Evitar la Ceguera en MéxicoMexico CityMexico
| | - Martin Zenker
- Institute of Human Genetics, University HospitalMagdeburgGermany
| | - Juan Carlos Zenteno
- Department of GeneticsInstitute of Ophthalmology “Conde de Valenciana”Mexico CityMexico
- Department of Biochemistry, Faculty of MedicineUNAMMexico CityMexico
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5
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Figueiras DDA, Leal DMDCB, Kozmhinsky V, Querino MCD, Regueira MGDS, Studart MGDM. Oculoectodermal syndrome: twentieth described case with new manifestations. An Bras Dermatol 2017; 91:160-162. [PMID: 28300929 PMCID: PMC5325028 DOI: 10.1590/abd1806-4841.20164409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 04/27/2015] [Indexed: 11/21/2022] Open
Abstract
Oculoectodermal syndrome is a rare disease characterized by the association of
aplasia cutis congenita, epibulbar dermoids, and other abnormalities. This
report describes the twentieth case of the disease. We report a 4-year-old
female child who presented with the classical features of the syndrome: aplasia
cutis congenita and epibulbar dermoids. Our case expands the clinical spectrum
of the disease to include: diffuse hyperpigmentation (some following the
Blaschko´s lines); hypopigmented skin areas on the trunk; arachnoid cyst on the
right fronto-parietal border; rounded left side of the hippocampus; and dermoid
cyst underlying the bulb-medullary transition. Our patient also reported
infantile hemangioma on the right wrist and verrucous hemangioma on the left
leg, the latter not previously described in the literature.
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Affiliation(s)
| | | | - Valter Kozmhinsky
- Instituto de Medicina Integral Professor Fernando Figueira (IMIP) - Recife (PE), Brazil
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Boppudi S, Bögershausen N, Hove H, Percin E, Aslan D, Dvorsky R, Kayhan G, Li Y, Cursiefen C, Tantcheva-Poor I, Toft P, Bartsch O, Lissewski C, Wieland I, Jakubiczka S, Wollnik B, Ahmadian M, Heindl L, Zenker M. Specific mosaicKRASmutations affecting codon 146 cause oculoectodermal syndrome and encephalocraniocutaneous lipomatosis. Clin Genet 2016; 90:334-42. [DOI: 10.1111/cge.12775] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 02/29/2016] [Accepted: 03/06/2016] [Indexed: 01/08/2023]
Affiliation(s)
- S. Boppudi
- Institute of Human Genetics; University Hospital Magdeburg, Otto-von-Guericke University; Magdeburg Germany
| | - N. Bögershausen
- Institute of Human Genetics; University Medical Center Goettingen, Georg-August University; Goettingen Germany
- Institute of Human Genetics; University of Cologne; Cologne Germany
| | - H.B. Hove
- Department of Clinical Genetics; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - E.F. Percin
- Department of Medical Genetics, Faculty of Medicine; Gazi University; Ankara Turkey
| | - D. Aslan
- Section of Hematology, Department of Pediatrics, Faculty of Medicine; Gazi University; Ankara Turkey
| | - R. Dvorsky
- Institute of Biochemistry and Molecular Biology II, Medical Faculty; Heinrich-Heine-University; Düsseldorf Germany
| | - G. Kayhan
- Department of Medical Genetics, Faculty of Medicine; Gazi University; Ankara Turkey
| | - Y. Li
- Institute of Human Genetics; University Medical Center Goettingen, Georg-August University; Goettingen Germany
- Institute of Human Genetics; University of Cologne; Cologne Germany
| | - C. Cursiefen
- Department of Ophthalmology; University of Cologne; Cologne Germany
| | | | - P.B. Toft
- Department of Ophthalmology; Copenhagen University Hospital Rigshospitalet; Copenhagen Denmark
| | - O. Bartsch
- Institute of Human Genetics; University Medical Centre of the Johannes Gutenberg University Mainz; Mainz Germany
| | - C. Lissewski
- Institute of Human Genetics; University Hospital Magdeburg, Otto-von-Guericke University; Magdeburg Germany
| | - I. Wieland
- Institute of Human Genetics; University Hospital Magdeburg, Otto-von-Guericke University; Magdeburg Germany
| | - S. Jakubiczka
- Institute of Human Genetics; University Hospital Magdeburg, Otto-von-Guericke University; Magdeburg Germany
| | - B. Wollnik
- Institute of Human Genetics; University Medical Center Goettingen, Georg-August University; Goettingen Germany
- Institute of Human Genetics; University of Cologne; Cologne Germany
| | - M.R. Ahmadian
- Institute of Biochemistry and Molecular Biology II, Medical Faculty; Heinrich-Heine-University; Düsseldorf Germany
| | - L.M. Heindl
- Department of Ophthalmology; University of Cologne; Cologne Germany
| | - M. Zenker
- Institute of Human Genetics; University Hospital Magdeburg, Otto-von-Guericke University; Magdeburg Germany
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7
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Peacock JD, Dykema KJ, Toriello HV, Mooney MR, Scholten DJ, Winn ME, Borgman A, Duesbery NS, Hiemenga JA, Liu C, Campbell S, Nickoloff BP, Williams BO, Steensma M. Oculoectodermal syndrome is a mosaic RASopathy associated withKRASalterations. Am J Med Genet A 2015; 167:1429-35. [DOI: 10.1002/ajmg.a.37048] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 02/18/2015] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - Helga V. Toriello
- Michigan State University College of Human Medicine; Grand Rapids; Michigan
| | | | - Donald J. Scholten
- Van Andel Research Institute; Grand Rapids; Michigan
- Michigan State University College of Human Medicine; Grand Rapids; Michigan
| | - Mary E. Winn
- Van Andel Research Institute; Grand Rapids; Michigan
| | | | | | | | - Cong Liu
- Spectrum Health; Grand Rapids; Michigan
| | | | - Brian P. Nickoloff
- Van Andel Research Institute; Grand Rapids; Michigan
- Michigan State University College of Human Medicine; Grand Rapids; Michigan
| | | | - Matthew Steensma
- Van Andel Research Institute; Grand Rapids; Michigan
- Michigan State University College of Human Medicine; Grand Rapids; Michigan
- Spectrum Health; Grand Rapids; Michigan
- Helen DeVos Children's Hospital, Grand Rapids Michigan
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