1
|
Conte A, De Padova D, Giglio S, Livellara V, Manzitti C, De Marco P, Capra V, Sorrentino S. Late Relapse in Genetically Determined Infantile Myofibromatosis. A Case Report and Brief Focus on Recurrences. J Pediatr Hematol Oncol 2024:00043426-990000000-00477. [PMID: 39141797 DOI: 10.1097/mph.0000000000002942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Infantile myofibromatosis (IM) is a rare disorder characterized by benign tumors in the skin, subcutaneous tissue, muscle, and occasionally viscera. IM can be hereditary due to PDGFRB or NOTCH3 variants. Treatment is mainly conservative or surgical. Combination regimens have been used in case of disseminated disease. OBSERVATION We present relapsed disease of IM 11 years after diagnosis in a 2-year-old child initially treated by microscopically complete resection. A new heterozygous c.1687G>A (p.Glu563Lys) mutation in the PDGFRB gene was identified (considered likely pathogenic). CONCLUSIONS In association with initial treatment, genetic testing is crucial for tailored clinical practice and follow-up in patients diagnosed with IM.
Collapse
Affiliation(s)
- Alessio Conte
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa
| | - Damiana De Padova
- Arcispedale Sant'Anna Medical Department, Azienda Ospedaliera Universitaria di Ferrara, Pediatrics Unit, SSD Pediatric Oncohematology, Cona (Ferrara)
| | - Serena Giglio
- UO Pediatria-Neonatologia/Nido PO A. Ajello ASP Trapani, Trapani, Italy
| | | | | | | | - Valeria Capra
- Genomics and Clinical Genetics Unit, IRCCS Giannina Gaslini, Genoa
| | | |
Collapse
|
2
|
De Martino L, Tresserras-Giné G, Quaglietta L, Spennato P, Errico M, Bifano D, Cinalli G. Giant intracranial infantile myofibromatosis of the skull base: report of two cases. Childs Nerv Syst 2022; 38:837-841. [PMID: 34244845 DOI: 10.1007/s00381-021-05271-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/18/2021] [Indexed: 11/28/2022]
Abstract
Infantile myofibromatosis is a rare and nonmalignant pediatric tumor of myofibroblastic origin that may occur in solitary or multifocal forms. Soft tissue of the head and neck, trunk, and extremities, skeleton, and viscera are usually involved. Intracranial involvement is reported to be extremely rare, and its clinical picture has been poorly characterized. We present two cases of giant infantile myofibromatosis of the skull base with intracranial involvement. The first case with prenatal diagnosis involved extensively the extradural space of the occipital region and was previously treated by chemotherapy for a previous diagnosis of hemangioperycitoma. Tumor was removed at the age of 5 months and no recurrence was observed during the 3-year follow-up. The second case in a 2-year-old baby involved the anterior cranial base, the nasal cavity, the right orbit, and presented massive involvement of the anterior cranial fossa. Surgery allowed complete removal and a recurrence-free period of 7 years after surgery. Treatment options for these unusual cases are presented and details of histological diagnosis are discussed.
Collapse
Affiliation(s)
- Lucia De Martino
- Department of Pediatric Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Gloria Tresserras-Giné
- Department of Pediatric Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy.,Department of Pathology, Santobono-Pausilipon Children's Hospital, Naples, Italy.,Department of Pediatric Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy.,Department of Neurosurgery, Hospital Universitari Dexeus, Barcelona, Spain
| | - Lucia Quaglietta
- Department of Pediatric Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Pietro Spennato
- Department of Pediatric Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Mariaelena Errico
- Department of Pathology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Delfina Bifano
- Department of Pathology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Giuseppe Cinalli
- Department of Pediatric Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy. .,Department of Pediatric Neurosciences, Pediatric Neurosurgery Unit, Santobono-Pausilipon Children's Hospital, Via Mario Fiore n. 6, 80129, Naples, Italy.
| |
Collapse
|
3
|
Römer T, Wagner N, Braunschweig T, Meyer R, Elbracht M, Kontny U, Moser O. Aggressive infantile myofibromatosis with intestinal involvement. Mol Cell Pediatr 2021; 8:7. [PMID: 34132909 PMCID: PMC8208328 DOI: 10.1186/s40348-021-00117-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 06/06/2021] [Indexed: 11/15/2022] Open
Abstract
Background Infantile myofibromatosis (IM) is the most common cause of multiple fibrous tumors in infancy. Multicentric disease can be associated with life-threatening visceral lesions. Germline gain-of-function mutations in PDGFRB have been identified as the most common molecular defect in familial IM. Case presentation We here describe an infant with PDGFRB-driven IM with multiple tumors at different sites, including intestinal polyposis with hematochezia, necessitating temporary chemotherapy. Conclusions PDGFRB-driven IM is clinically challenging due to its fluctuating course and multiple organ involvement in the first years of life. Early molecular genetic analysis is necessary to consider tyrosine kinase inhibitor treatment in case of aggressive visceral lesions.
Collapse
Affiliation(s)
- Tristan Römer
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Pauwelstrasse 30, 52074, Aachen, Germany.
| | - Norbert Wagner
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Pauwelstrasse 30, 52074, Aachen, Germany
| | | | - Robert Meyer
- Institute of Human Genetics, RWTH Aachen University, Aachen, Germany
| | - Miriam Elbracht
- Institute of Human Genetics, RWTH Aachen University, Aachen, Germany
| | - Udo Kontny
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Pauwelstrasse 30, 52074, Aachen, Germany
| | - Olga Moser
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Pauwelstrasse 30, 52074, Aachen, Germany
| |
Collapse
|
4
|
Dachy G, Fraitag S, Boulouadnine B, Cordi S, Demoulin JB. Novel COL4A1-VEGFD gene fusion in myofibroma. J Cell Mol Med 2021; 25:4387-4394. [PMID: 33830670 PMCID: PMC8093964 DOI: 10.1111/jcmm.16502] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 12/18/2022] Open
Abstract
Myofibroma is a benign pericytic tumour affecting young children. The presence of multicentric myofibromas defines infantile myofibromatosis (IMF), which is a life‐threatening condition when associated with visceral involvement. The disease pathophysiology remains poorly characterized. In this study, we performed deep RNA sequencing on eight myofibroma samples, including two from patients with IMF. We identified five different in‐frame gene fusions in six patients, including three previously described fusion transcripts, SRF‐CITED1, SRF‐ICA1L and MTCH2‐FNBP4, and a fusion of unknown significance, FN1‐TIMP1. We found a novel COL4A1‐VEGFD gene fusion in two cases, one of which also carried a PDGFRB mutation. We observed a robust expression of VEGFD by immunofluorescence on the corresponding tumour sections. Finally, we showed that the COL4A1‐VEGFD chimeric protein was processed to mature VEGFD growth factor by proteases, such as the FURIN proprotein convertase. In conclusion, our results unravel a new recurrent gene fusion that leads to VEGFD production under the control of the COL4A1 gene promoter in myofibroma. This fusion is highly reminiscent of the COL1A1‐PDGFB oncogene associated with dermatofibrosarcoma protuberans. This work has implications for the diagnosis and, possibly, the treatment of a subset of myofibromas.
Collapse
Affiliation(s)
- Guillaume Dachy
- de Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Sylvie Fraitag
- Department of Pathology, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Sabine Cordi
- de Duve Institute, Université Catholique de Louvain, Brussels, Belgium
| | | |
Collapse
|
5
|
Guérit E, Arts F, Dachy G, Boulouadnine B, Demoulin JB. PDGF receptor mutations in human diseases. Cell Mol Life Sci 2021; 78:3867-3881. [PMID: 33449152 PMCID: PMC11072557 DOI: 10.1007/s00018-020-03753-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/16/2020] [Accepted: 12/29/2020] [Indexed: 12/16/2022]
Abstract
PDGFRA and PDGFRB are classical proto-oncogenes that encode receptor tyrosine kinases responding to platelet-derived growth factor (PDGF). PDGFRA mutations are found in gastrointestinal stromal tumors (GISTs), inflammatory fibroid polyps and gliomas, and PDGFRB mutations drive myofibroma development. In addition, chromosomal rearrangement of either gene causes myeloid neoplasms associated with hypereosinophilia. Recently, mutations in PDGFRB were linked to several noncancerous diseases. Germline heterozygous variants that reduce receptor activity have been identified in primary familial brain calcification, whereas gain-of-function mutants are present in patients with fusiform aneurysms, Kosaki overgrowth syndrome or Penttinen premature aging syndrome. Functional analysis of these variants has led to the preclinical validation of tyrosine kinase inhibitors targeting PDGF receptors, such as imatinib, as a treatment for some of these conditions. This review summarizes the rapidly expanding knowledge in this field.
Collapse
Affiliation(s)
- Emilie Guérit
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium
| | - Florence Arts
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium
| | - Guillaume Dachy
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium
| | - Boutaina Boulouadnine
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium
| | - Jean-Baptiste Demoulin
- De Duve Institute, Université Catholique de Louvain, Avenue Hippocrate 75, Box B1.74.05, 1200, Brussels, Belgium.
| |
Collapse
|
6
|
Chenbhanich J, Hu Y, Hetts S, Cooke D, Dowd C, Devine P, Russell B, Kang SHL, Chang VY, Abla AA, Cornett P, Yeh I, Lee H, Martinez-Agosto JA, Frieden IJ, Shieh JT. Segmental overgrowth and aneurysms due to mosaic PDGFRB p.(Tyr562Cys). Am J Med Genet A 2021; 185:1430-1436. [PMID: 33683022 DOI: 10.1002/ajmg.a.62126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/18/2020] [Accepted: 01/14/2021] [Indexed: 01/19/2023]
Abstract
Activating variants in the platelet-derived growth factor receptor β gene (PDGFRB) have been associated with Kosaki overgrowth syndrome, infantile myofibromatosis, and Penttinen premature aging syndrome. A recently described phenotype with fusiform aneurysm has been associated with mosaic PDGFRB c.1685A > G p.(Tyr562Cys) variant. Few reports however have examined the vascular phenotypes and mosaic effects of PDGFRB variants. We describe clinical characteristics of two patients with a recurrent mosaic PDGFRB p.(Tyr562Cys) variant identified via next-generation sequencing-based genetic testing. We observed intracranial fusiform aneurysm in one patient and found an additional eight patients with aneurysms and phenotypes associated with PDGFRB-activating variants through literature search. The conditions caused by PDGFRB-activating variants share overlapping features including overgrowth, premature aged skin, and vascular malformations including aneurysms. Aneurysms are progressive and can result in morbidities and mortalities in the absence of successful intervention. Germline and/or somatic testing for PDGFRB gene should be obtained when PDGFRB activating variant-related phenotypes are present. Whole-body imaging of the arterial tree and echocardiography are recommended after diagnosis. Repeating the imaging study within a 6- to 12-month period after detection is reasonable. Finally, further evaluation for the effectiveness and safety profile of kinase inhibitors in this patient population is warranted.
Collapse
Affiliation(s)
- Jirat Chenbhanich
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Yan Hu
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Steven Hetts
- Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Daniel Cooke
- Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Christopher Dowd
- Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Patrick Devine
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, California, USA.,Institute of Human Genetics, University of California, San Francisco, California, USA
| | | | - Bianca Russell
- Department of Pediatrics, Division of Medical Genetics, University of California Los Angeles, Los Angeles, California, USA
| | - Sung Hae L Kang
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Vivian Y Chang
- Department of Pediatrics, Division of Pediatric Hematology Oncology, University of California Los Angeles, Los Angeles, California, USA
| | - Adib A Abla
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Patricia Cornett
- Department of Hematology and Oncology, University of California, San Francisco, California, USA
| | - Iwei Yeh
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, California, USA.,Department of Dermatology, University of California, San Francisco, California, USA
| | - Hane Lee
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California, USA.,Department of Human Genetics, University of California Los Angeles, Los Angeles, California, USA
| | - Julian A Martinez-Agosto
- Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.,Department of Human Genetics, University of California Los Angeles, Los Angeles, California, USA
| | - Ilona J Frieden
- Department of Dermatology, University of California, San Francisco, California, USA
| | - Joseph T Shieh
- Division of Medical Genetics, Department of Pediatrics, University of California, San Francisco, California, USA.,Institute of Human Genetics, University of California, San Francisco, California, USA
| |
Collapse
|
7
|
Proust S, Benchimol G, Fraitag S, Starck J, Giacobbi V, Pierron G, Bodemer C, Orbach D. Major response to imatinib and chemotherapy in a newborn patient prenatally diagnosed with generalized infantile myofibromatosis. Pediatr Blood Cancer 2021; 68:e28576. [PMID: 32896962 DOI: 10.1002/pbc.28576] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/26/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Stéphanie Proust
- Pediatric Oncology Department, University Hospital, Angers, France
| | - Gabriel Benchimol
- Obstetrics and Fetal Medicine Department, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Sylvie Fraitag
- Pathology Department, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Julie Starck
- Intensive Care Unit, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | | | - Gaelle Pierron
- Department of Somatic Genetic, Institut Curie, Paris, France
| | - Christine Bodemer
- Reference Centre for Genodermatoses and Rare Skin Disease (MAGEC), Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| |
Collapse
|
8
|
de Siqueira EC, de Sousa SF, Carlos R, de Andrade BAB, Romañach MJ, Gomez RS, Gomes CC. Odontogenic myxomas lack PDGFRB mutations reported in myofibromas. J Oral Pathol Med 2020; 49:278-283. [PMID: 32050038 DOI: 10.1111/jop.13004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/17/2019] [Accepted: 02/07/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The molecular pathogenesis of odontogenic myxoma has not been established yet. Considering that odontogenic myxoma may show myofibroblastic differentiation and myxoid areas can be observed in intra-osseous myofibromas, we tested the hypothesis whether both tumors share a common molecular profile. As recent studies have reported PDGFRB recurrent driver mutations in myofibroma, we evaluated PDGFRB mutations in odontogenic myxomas. METHODS A convenience sample of 15 odontogenic myxomas cases was selected. We direct sequenced PDGFRB exons 12 and 14, where p.R561C (c.1681C>T) and p.N666K (c.1998C>G) hotspot mutations have been reported among others in single and/or multiple myofibromas. RESULTS All 15 odontogenic myxoma samples were successfully sequenced, and all 15 had wild-type sequences for the PDGFRB mutations investigated. CONCLUSION Our findings suggest that PDGFRB mutations do not play a role in odontogenic myxoma pathogenesis, which might be helpful in the differential diagnosis of challenging cases.
Collapse
Affiliation(s)
| | - Silvia Ferreira de Sousa
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Roman Carlos
- Departament of Pathology, Hospital Herrera-Llerandi/AMEDESGUA, Guatemala City, Guatemala
| | | | - Mário José Romañach
- Departament of Oral Diagnosis and Pathology, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | |
Collapse
|
9
|
Takenouchi T, Okuno H, Kosaki K. Kosaki overgrowth syndrome: A newly identified entity caused by pathogenic variants in platelet‐derived growth factor receptor‐beta. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2019; 181:650-657. [DOI: 10.1002/ajmg.c.31755] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 12/20/2022]
Affiliation(s)
| | - Hironobu Okuno
- Department of PhysiologyKeio University School of Medicine Tokyo Japan
| | - Kenjiro Kosaki
- Center for Medical GeneticsKeio University School of Medicine Tokyo Japan
| |
Collapse
|