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Schlaht KM, Sas DJ, Davis DMR, Hand JL. An investigation of metabolic disturbances, including urinary stone disease, hypothyroidism, and osteoporosis in basal cell nevus syndrome. Pediatr Dermatol 2022; 39:713-717. [PMID: 35574616 DOI: 10.1111/pde.15022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES Basal cell nevus syndrome (BCNS) is an autosomal dominant skin cancer predisposition syndrome associated with abnormal mineral metabolism, a risk factor for urinary stone disease (USD). However, no research investigating the association between BCNS and USD or other manifestations of abnormal mineral metabolism has been conducted. The objective of this study is to investigate the association between BCNS and conditions associated with disordered mineral metabolism including USD, hypothyroidism, and osteoporosis and compare them to prevalence in the general population to elucidate potential unknown manifestations of the condition. METHODS This retrospective study examined medical records of adult and pediatric patients with confirmed BCNS from the Mayo Clinic database from 1 January 1995 to 12 January 2020. Records were surveyed for evidence of USD and other comorbidities potentially related to BCNS. The studied cohort included 100 adult patients and 5 pediatric patients. RESULTS A total of 105 patients were included in this analysis, 10 of whom experienced confirmed USD, representing a prevalence of 10%. Six adult patients were identified with a diagnosis of osteoporosis, representing a prevalence of 6%. Thirteen adult patients were identified with a diagnosis of hypothyroidism, representing a prevalence of 13%. CONCLUSIONS This study identified a prevalence of USD in BCNS patients comparable to estimates of national prevalence, indicating that known abnormalities in mineral metabolism likely do not increase the incidence of USD in BCNS patients. Additional findings included increased prevalence of hypothyroidism and decreased prevalence of osteoporosis in the BCNS cohort compared to national averages.
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Affiliation(s)
- Karl M Schlaht
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA
| | - David J Sas
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Dawn Marie R Davis
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer L Hand
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Clinical Genomics, Mayo Clinic, Rochester, Minnesota, USA
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Verkouteren BJ, Roemen GM, Schuurs-Hoeijmakers JH, Abdul Hamid M, van Geel M, Speel EJM, Mosterd K. Molecular mechanism of extracutaneous tumours in patients with basal cell nevus syndrome. J Clin Pathol 2022; 76:345-348. [PMID: 36002246 DOI: 10.1136/jcp-2022-208391] [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: 05/13/2022] [Accepted: 07/27/2022] [Indexed: 11/03/2022]
Abstract
Basal cell nevus syndrome (BCNS) is a rare genetic disorder accompanied by a broad variety of tumours, of which basal cell carcinomas and odontogenic keratocysts are the most common. BCNS is caused by a germline or postzygotic mutation in either PTCH1 or SUFU As BCNS is a rare disease, it is difficult to establish whether less frequently occurring tumours are actually part of the syndrome. In this study, the molecular mechanism behind four extracutaneous tumours in patients with BCNS was elucidated. A leiomyoma of the testis and meningioma were confirmed to be associated with BCNS in two patients by presence of a second mutation or loss of heterozygosity in PTCH1 In a meningioma of a patient with a mosaic postzygotic PTCH1 mutation an association could not be conclusively confirmed. SUFU was probably not involved in the development of a thyroid carcinoma in a patient with a germline SUFU mutation. Hence, we have proven that meningioma and leiomyoma of the testis are rare extracutaneous tumours that are part of BCNS.
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Affiliation(s)
- Babette Ja Verkouteren
- Department of Dermatology, Maastricht University Medical Center+, Maastricht, The Netherlands .,GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Guido Mjm Roemen
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.,Department of Pathology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | | | - Myrurgia Abdul Hamid
- Department of Pathology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Michel van Geel
- Department of Dermatology, Maastricht University Medical Center+, Maastricht, The Netherlands.,GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.,Department of Clinical Genetics, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ernst-Jan M Speel
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.,Department of Pathology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Klara Mosterd
- Department of Dermatology, Maastricht University Medical Center+, Maastricht, The Netherlands.,GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
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3
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Alonso N, Cañueto J, Ciria S, Bueno E, Palacios-Alvarez I, Alegre M, Badenas C, Barreiro A, Pena L, Maldonado C, Nespeira-Jato MV, Peña-Penabad C, Azon A, Gavrilova M, Ferrer I, Sanmartin O, Robles L, Hernandez-Martin A, Urioste M, Puig S, Puig L, Gonzalez-Sarmiento R. Novel clinical and molecular findings in Spanish patients with naevoid basal cell carcinoma syndrome. Br J Dermatol 2017; 178:198-206. [PMID: 28733979 DOI: 10.1111/bjd.15835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Naevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder characterized by developmental alterations and multiple basal cell carcinomas. Mutations in PTCH1, which encodes a membrane receptor for Sonic Hedgehog, are associated with the development of the disease. Most of them produce a truncated protein, which is unable to suppress Smoothened protein and continuously activates the downstream pathway. OBJECTIVES We aimed to characterize 22 unrelated Spanish patients with NBCCS, the largest cohort with Gorlin syndrome reported to date in Spain. METHODS Genomic analysis of PTCH1 was performed in patients with NBCCS and controls, and mutations were analysed using bioinformatics tools. RESULTS We report for the first time two young patients, one each with uterus didelphys and ganglioneuroma, within the context of NBCCS. One patient showing a severe phenotype of the disease had developed basal cell carcinomas since childhood. Sanger sequencing of PTCH1 in this cohort identified 17 novel truncating mutations (11 frameshift, five nonsense and one mutation affecting an exon-intron splice site) and two novel missense mutations that were predicted to be pathogenic. The patients showed great clinical variability and inconsistent genotype-phenotype correlation, as seen in relatives carrying similar mutations. CONCLUSIONS This study contributes to increase the pool of clinical manifestations of NBCCS, as well as increasing the number of pathogenic mutations identified in PTCH1 predisposing to the condition. The inconsistencies found between phenotype and genotype suggest the involvement of other modifying factors, genetic, epigenetic or environmental.
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Affiliation(s)
- N Alonso
- Molecular Medicine Unit, Department of Medicine, University of Salamanca, Salamanca, Spain.,Rheumatology and Bone Disease Unit, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, U.K
| | - J Cañueto
- Department of Dermatology, Salamanca University Hospital, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University Hospital of Salamanca, University of Salamanca-CSIC, Salamanca, Spain
| | - S Ciria
- Molecular Medicine Unit, Department of Medicine, University of Salamanca, Salamanca, Spain
| | - E Bueno
- Molecular Medicine Unit, Department of Medicine, University of Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University Hospital of Salamanca, University of Salamanca-CSIC, Salamanca, Spain
| | | | - M Alegre
- Department of Dermatology, Hospital Santa Creu i San Pau, Barcelona, Spain
| | - C Badenas
- Biochemistry and Molecular Genetics, Melanoma Unit, Hospital Clinic i Provincial, Barcelona, Spain.,Institut de Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain
| | - A Barreiro
- Department of Dermatology, Melanoma Unit, Hospital Clinic i Provincial, Barcelona, Spain
| | - L Pena
- Familial Cancer Clinical Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - C Maldonado
- Department of Dermatology, Hospital Central de Asturias, Oviedo, Spain
| | - M V Nespeira-Jato
- Department of Dermatology, Hospital Universitario de La Coruña, La Coruña, Spain
| | - C Peña-Penabad
- Department of Dermatology, Hospital Universitario de La Coruña, La Coruña, Spain
| | - A Azon
- Department of Dermatology, Hospital San Joan de Reus, Reus, Spain
| | - M Gavrilova
- Department of Dermatology, Hospital Clínico de Valencia, Valencia, Spain
| | - I Ferrer
- Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
| | - O Sanmartin
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - L Robles
- Hereditary Cancer Unit, Hospital 12 de Octubre, Madrid, Spain
| | | | - M Urioste
- Familial Cancer Clinical Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - S Puig
- Institut de Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain.,Department of Dermatology, Melanoma Unit, Hospital Clinic i Provincial, Barcelona, Spain
| | - L Puig
- Department of Dermatology, Hospital Santa Creu i San Pau, Barcelona, Spain
| | - R Gonzalez-Sarmiento
- Molecular Medicine Unit, Department of Medicine, University of Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University Hospital of Salamanca, University of Salamanca-CSIC, Salamanca, Spain
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