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Ohlsen TJD, Scanlon S, Perez FA, Ermoian RP, Paulson VA, Hauptman JS, Crotty EE, Ting MA. Synchronous rare tumors in a pediatric patient with a de novo cancer predisposition syndrome. Pediatr Blood Cancer 2022; 69:e29746. [PMID: 35484874 DOI: 10.1002/pbc.29746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Timothy J D Ohlsen
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Samantha Scanlon
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Francisco A Perez
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Ralph P Ermoian
- Department of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Vera A Paulson
- Department of Laboratory Medicine & Pathology, University of Washington, Seattle, Washington, USA
| | - Jason S Hauptman
- Department of Neurosurgery, University of Washington, Seattle, Washington, USA.,Division of Pediatric Neurosurgery, Seattle Children's Hospital, Seattle, Washington, USA
| | - Erin E Crotty
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Michelle A Ting
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
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Yi JS, Kamihara J, Kesselheim JC, Davies K, van Hoff J, Silverman LB, Mullen EA. Synchronous occurrence of acute lymphoblastic leukemia and wilms tumor in two patients: underlying etiology and combined treatment plan. Pediatr Blood Cancer 2017; 64. [PMID: 27862952 DOI: 10.1002/pbc.26345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 09/08/2016] [Accepted: 10/06/2016] [Indexed: 11/06/2022]
Abstract
Synchronous cancers are extraordinarily rare in pediatric patients and present a therapeutic challenge. Patient A presented with synchronous unilateral Wilms tumor (WT) and standard-risk (SR) B-precursor acute lymphoblastic leukemia (ALL). Genetic testing revealed bialleleic BRCA2/FANCD1 mutations. Patient B, after SR B-precursor ALL induction therapy, was noted on fever workup to have a renal mass; pathology demonstrated lesion indeterminate between WT and nephrogenic rest. Therapy was customized for each patient to treat both cancers. Both patients have ongoing remission from their cancers, without excessive toxicity. We report two regimens for treating synchronous WT and ALL and recommend screening such patients for cancer predisposition.
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Affiliation(s)
- Joanna S Yi
- Pediatric Hematology/Oncology, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas
| | - Junne Kamihara
- Department of Pediatric Oncology, Dana-Farber/Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Jennifer C Kesselheim
- Department of Pediatric Oncology, Dana-Farber/Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Kimberly Davies
- Department of Pediatric Oncology, Dana-Farber/Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Jack van Hoff
- Pediatric Hematology/Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Lewis B Silverman
- Department of Pediatric Oncology, Dana-Farber/Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth A Mullen
- Department of Pediatric Oncology, Dana-Farber/Cancer Institute, Harvard Medical School, Boston, Massachusetts
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Schniederjan MJ, Shehata B, Brat DJ, Esiashvili N, Janss AJ. De novo germline TP53 mutation presenting with synchronous malignancies of the central nervous system. Pediatr Blood Cancer 2009; 53:1352-4. [PMID: 19711436 DOI: 10.1002/pbc.22214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We present a case of a 14-year-old male with a germline TP53 mutation who presented with synchronous primitive neuroectodermal tumor and choroid plexus carcinoma. Identification of synchronous brain tumors prompted genetic testing for predisposition to malignancy. Within 5 months of presentation, the child developed widely metastatic alveolar rhabdomyosarcoma. Patient DNA sequencing showed a TP53 allele with a premature stop codon in the oligomerization/nuclear export signal (NES) domain (R342ter). The child's parents, younger brother, paternal grandparents, and maternal grandmother, are without history of malignancy. The patient's brother tested negative for TP53 mutations. This case identifies a rare, de novo, germline TP53 mutation presenting with synchronous CNS malignancies and exhibiting a more fulminant course than typical cases of Li-Fraumeni syndrome.
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Affiliation(s)
- Matthew J Schniederjan
- Department of Pathology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
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TP53 germline mutations in Portugal and genetic modifiers of age at cancer onset. Fam Cancer 2009; 8:383-90. [PMID: 19468865 DOI: 10.1007/s10689-009-9251-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2009] [Accepted: 05/14/2009] [Indexed: 10/20/2022]
Abstract
The Li-Fraumeni syndrome (LFS) is a rare, autosomal dominant disease caused by TP53 germline mutations. This study aimed to characterize the TP53 mutational spectrum in patients suspected to have LFS in Portugal and to evaluate the influence of the MDM2-SNP309 and TP53-72Arg variants and of telomere length on age of tumor onset. Probands were primarily selected using the classical LFS criteria (two cases) or the more sensitive Chompret Li-Fraumeni-like (LFL) criteria (13 cases), but 12 additional patients that did not comply with those LFS or LFL criteria were included in the analysis based on clinical suspicion (LFS suspects). Nine of the 27 probands (33.3%) presented germline TP53 mutations, two of them occurring de novo and two of them being novel. Three of the nine TP53 mutations were found in families that did not comply with any of the commonly used criteria for TP53 testing, leaving room to recommend the use of less stringent criteria. An association was found between the presence of the TP53-72Arg (but not the MDM2-SNP309) variant and earlier age of onset in TP53 carriers. A negative correlation between telomere length and age of cancer onset was found in patients with germline TP53 mutation, whereas no such correlation was found in controls or in patients with wild-type TP53.
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