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Schultewolter JH, Rissmann A, von Schweinitz D, Frühwald M, Blattmann C, Fischer L, Lange BS, Wessalowski R, Fröhlich B, Behnisch W, Schmid I, Reinhard H, Dürken M, Hundsdörfer P, Heimbrodt M, Vokuhl C, Schönberger S, Schneider DT, Seitz G, Looijenga L, Göbel U, von Kries R, Reutter H, Calaminus G. Non-Syndromic and Syndromic Defects in Children with Extracranial Germ Cell Tumors: Data of 2610 Children Registered with the German MAKEI 96/MAHO 98 Registry Compared to the General Population. Cancers (Basel) 2024; 16:2157. [PMID: 38893276 PMCID: PMC11172205 DOI: 10.3390/cancers16112157] [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: 04/19/2024] [Revised: 05/23/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
GCTs are developmental tumors and are likely to reflect ontogenetic and teratogenetic determinants. The objective of this study was to identify syndromes with or without congenital anomalies and non-syndromic defects as potential risk factors. Patients with extracranial GCTs (eGCTs) registered in MAKEI 96/MAHO 98 between 1996 and 2017 were included. According to Teilum's holistic concept, malignant and benign teratomas were registered. We used a case-control study design with Orphanet as a reference group for syndromic defects and the Mainz birth registry (EUROCAT) for congenital anomalies at birth. Co-occurring genetic syndromes and/or congenital anomalies were assessed accordingly. Odds ratios and 95% confidence intervals were calculated and p-values for Fisher's exact test with Bonferroni correction if needed. A strong association was confirmed for Swyer (OR 338.6, 95% CI 43.7-2623.6) and Currarino syndrome (OR 34.2, 95% CI 13.2-88.6). We additionally found 16 isolated cases of eGCT with a wide range of syndromes. However, these were not found to be significantly associated following Bonferroni correction. Most of these cases pertained to girls. Regarding non-syndromic defects, no association with eGCTs could be identified. In our study, we confirmed a strong association for Swyer and Currarino syndromes with additional congenital anomalies.
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Affiliation(s)
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty, Otto-von-Guericke University, 39106 Magdeburg, Germany;
| | - Dietrich von Schweinitz
- Dr. von Haunersches Kinderspital, Department of Paediatric Surgery, University of Munich, 80539 Munich, Germany;
| | - Michael Frühwald
- Department of Pediatric and Adolescent Medicine, University Medical Center Augsburg, 86159 Augsburg, Germany;
| | - Claudia Blattmann
- Centre for Childhood, Adolescents and Female Medicine, Paediatrics 5 (Oncology, Hämatology, Immunology), Olgahospital Klinikum Stuttgart, 70174 Stuttgart, Germany;
| | - Lars Fischer
- Clinic for Childhood and Adolescent Medicine, Paediatric Oncology, University Hospital Leipzig (Universitätsklinikum Leipzig AöR), 04103 Leipzig, Germany;
| | - Björn Sönke Lange
- Clinic for Childhood and Adolescent Medicine, Paediatric Haematology and Oncology, University Hospital Dresden, 01307 Dresden, Germany;
| | - Rüdiger Wessalowski
- Clinic for Paediatric Hematology, Oncology and Immunology, University Childrens Hospital Düsseldorf, 40225 Düsseldorf, Germany; (R.W.); (U.G.)
| | - Birgit Fröhlich
- Clinic for Paediatric Hematology and Oncology, University of Münster, 48149 Münster, Germany;
| | - Wolfgang Behnisch
- Department of Paediatric Haematology and Oncology, University Childrens Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Irene Schmid
- Dr. von Haunersches Kinderspital, Department of Paediatric Haematology and Oncology, University of Munich, 80539 Munich, Germany;
| | - Harald Reinhard
- Department of Paediatric Haematology and Oncology, Asklepios Hospital Sankt Augustin, 53757 St. Augustin, Germany;
| | - Matthias Dürken
- Clinic for Childhood and Adolescent Medicine, Paediatric Haematology and Oncology, Medical Faculty Mannheim, University of Heidelberg, 69117 Heidelberg, Germany;
| | - Patrick Hundsdörfer
- Clinic for Childhood and Adolescent Medicine, Oncology Haematology, HELIOS Clinic Berlin-Buch, 13125 Berlin, Germany;
| | - Martin Heimbrodt
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, 53127 Bonn, Germany; (M.H.); (G.C.)
| | - Christian Vokuhl
- Department of Pathology, Section Paidopathology, University Hospital Bonn, 53127 Bonn, Germany;
| | - Stefan Schönberger
- Department of Pediatric Hematology and Oncology, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany;
| | - Dominik T. Schneider
- Clinic of Paediatrics, Klinikum Dortmund, University Witten/Herdecke, 58448 Witten, Germany;
| | - Guido Seitz
- Department of Pediatric Surgery and Urology, University Hospital Giessen-Marburg, Campus Marburg, 35037 Marburg, Germany;
- Department of Pediatric Surgery, University Hospital Giessen-Marburg, Campus Giessen, 35392 Giessen, Germany
| | - Leendert Looijenga
- Princess Máxima Center for Pediatric Oncology, 3584 Utrecht, The Netherlands;
| | - Ulrich Göbel
- Clinic for Paediatric Hematology, Oncology and Immunology, University Childrens Hospital Düsseldorf, 40225 Düsseldorf, Germany; (R.W.); (U.G.)
| | - Rüdiger von Kries
- Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, LMU Munich, 80539 Munich, Germany;
| | - Heiko Reutter
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, 91054 Erlangen, Germany;
| | - Gabriele Calaminus
- Department of Pediatric Hematology and Oncology, University Hospital Bonn, 53127 Bonn, Germany; (M.H.); (G.C.)
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Behera G, Manekar A, Mahallik S, Sable M, Das K. Currarino syndrome with immature teratoma: A case report with review of literature. J Cancer Res Ther 2024; 20:1088-1091. [PMID: 39023623 DOI: 10.4103/jcrt.jcrt_1142_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/06/2020] [Indexed: 07/20/2024]
Abstract
ABSTRACT Currarino syndrome (CS) is a rare congenital syndrome characterized by a triad of anorectal malformation, sacral deformity, and presacral mass. In about 50% of cases, it is caused by HLXB9 gene mutation in chromosome 7q36. A 13-month-male child presented with presacral discharging sinus with a history of surgery for anorectal malformation and perineal fistula at the time of birth. On detailed investigation, the child revealed to have anal atresia, hemisacrum, and presacral mass. Histopathology of presacral mass showed features of immature teratoma. The presacral mass in CS is mostly an anterior myelomeningocele or presacral teratoma. The development of immature teratoma in presacral mass is very rare. The histopathological identification of immature component of teratoma in the presacral mass of CS is important for risk stratification and further management. Suspicion of CS should be raised in any child presenting with partial phenotype of the triad.
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Affiliation(s)
- Gayatri Behera
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Aaditya Manekar
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Santosh Mahallik
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mukund Sable
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanishka Das
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Nguyen BD. 18F-FDG PET/CT of Malignant Presacral Masses in Currarino Syndrome. Clin Nucl Med 2022; 47:e158-e160. [PMID: 35006115 DOI: 10.1097/rlu.0000000000003878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The Currarino syndrome is characterized by 3 main features: anorectal malformation, presacral lesion, and dysgenesis of the sacrum and coccyx. The presacral lesion is usually benign with a rare occurrence of malignant degeneration. The author presents 2 cases of Currarino syndrome with presacral mucinous adenocarcinoma and neuroendocrine tumor depicted by 18F FDG PET/CT.
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Affiliation(s)
- Ba D Nguyen
- From the Department of Radiology, Mayo Clinic, Scottsdale, AZ
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Sakurai T, Nakamura M, Endo N. Postoperative complications and long-term outcomes in Currarino syndrome. Pediatr Surg Int 2021; 37:1773-1781. [PMID: 34462793 DOI: 10.1007/s00383-021-04984-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to present ten cases of Currarino syndrome, study their postoperative complications and prognosis, and analyze whether patient background and clinical factors influenced outcomes. METHODS Ten patients with Currarino syndrome who were followed up at our institution between 2004 and 2020 were enrolled. Patient records were retrospectively reviewed for clinical details, postoperative complications, and long-term outcomes. RESULTS The incidence of early postoperative complications was 80%, most of which were transient dysuria. The dysuria significantly developed in the higher normal sacral vertebra (p = 0.024) and the complete type of Currarino syndrome (p = 0.033). Later, intractable constipation requiring rectal irrigation and intractable dysuria requiring clean intermittent catheterization occurred in 40% and 30% of the patients, respectively. There was a tendency for tethered cord syndrome (p = 0.076), and the height of the normal sacral vertebra (p = 0.071) was related to intractable constipation. The height of the normal sacral vertebra (p = 0.05) and the tumor size on the image (p = 0.012) were significantly higher and larger, respectively, in the group with intractable dysuria than in the group without intractable dysuria. CONCLUSION Postoperative complications, especially early ones, occur at a high rate. Long-term intractable constipation and dysuria may be influenced by the degree of sacral dysplasia.
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Affiliation(s)
- Tsuyoshi Sakurai
- Department of Pediatric Surgery, Miyagi Children's Hospital, Sendai, 989-3126, Japan
| | - Megumi Nakamura
- Department of Pediatric Surgery, Miyagi Children's Hospital, Sendai, 989-3126, Japan
| | - Naobumi Endo
- Department of Pediatric Surgery, Miyagi Children's Hospital, Sendai, 989-3126, Japan.
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Matrood S, Apostolidis L, Schrader J, Krug S, Lahner H, Ramaswamy A, Librizzi D, Kender Z, Kröcher A, Kreutzfeldt S, Gress TM, Rinke A. Multicenter Analysis of Presacral Neuroendocrine Neoplasms-Clinicopathological Characterization and Treatment Outcomes of a Rare Disease. Front Endocrinol (Lausanne) 2021; 12:709256. [PMID: 34690926 PMCID: PMC8527170 DOI: 10.3389/fendo.2021.709256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Aims Neuroendocrine neoplasms (NENs) of the presacral space are an extremely rare disease entity with largely unknown outcome and no established standard of care treatment. Therefore, we wanted to analyze clinical presentation, histopathological findings, treatment outcomes, and prognosis in a multicentric patient cohort. Methods We searched local databases of six German NEN centers for patients with presacral NEN. Retrospective descriptive analyses of age, sex, stage at diagnosis, symptoms, grade, immunohistochemical investigations, biomarkers, treatment, and treatment outcome were performed. Kaplan-Meier analysis was used to determine median overall survival. Results We identified 17 patients (11 female, 6 male) with a median age of 50 years (range, 35-66) at diagnosis. Twelve cases presented initially with distant metastases including bone metastases in nine cases. On pathological review the majority of patients had well-differentiated G2 tumors. Immunohistochemical profile resembled rectal NENs. All but one patient had non-functioning tumors. Somatostatin receptor imaging was positive in 14 of 15 investigated cases. Eight patients were treated surgically including palliative resections; 14 patients received somatostatin analogs with limited efficacy. With 14 PRRTs completed, 79% showed clinical benefit, whereas only one patient with neuroendocrine carcinoma (NEC) responded to chemotherapy. Treatment with everolimus in three patients was not successful, whereas cabozantinib resulted in a disease stabilization in a heavily pretreated patient. During a median observation period of 44.5 months, 6 patients died. Median overall survival was not reached. Conclusion Presacral NEN are histopathologically similar to rectal NENs. Presacral NEN should be considered as possible primary in NEN of unknown primary. The majority of tumors is non-functioning and somatostatin receptor positive. PRRT demonstrated promising activity; tyrosine kinase inhibitors warrant further investigations. Further molecular characterization and prospective evaluation of this rare tumor entity are needed.
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Affiliation(s)
- Sami Matrood
- Department of Gastroenterology and Endocrinology, UKGM Marburg and Philipps University, Marburg, Germany
| | - Leonidas Apostolidis
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital, Heidelberg, Germany
| | - Jörg Schrader
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Krug
- Clinic for Internal Medicine I, Martin-Luther University Halle/Wittenberg, Halle, Germany
| | - Harald Lahner
- Department of Endocrinology and Metabolism, University Hospital Essen, Essen, Germany
| | - Annette Ramaswamy
- Institute of Pathology, UKGM Marburg and Philipps University, Marburg, Germany
| | - Damiano Librizzi
- Department of Nuclear Medicine, UKGM Marburg and Philipps University, Marburg, Germany
| | - Zoltan Kender
- Department of Internal Medicine I and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Anke Kröcher
- Clinic for Internal Medicine I, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Simon Kreutzfeldt
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Thomas Matthias Gress
- Department of Gastroenterology and Endocrinology, UKGM Marburg and Philipps University, Marburg, Germany
| | - Anja Rinke
- Department of Gastroenterology and Endocrinology, UKGM Marburg and Philipps University, Marburg, Germany
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Correa Bonito A, Maqueda González R, Rodríguez Sánchez A, Bermejo Marcos E, Blanco Terés L, García Septiem J, Martín Pérez E. Presacral neuroendocrine tumour in a patient diagnosed with Currarino's syndrome. GASTROENTEROLOGIA Y HEPATOLOGIA 2021; 45 Suppl 1:62-63. [PMID: 34023472 DOI: 10.1016/j.gastrohep.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/20/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Alba Correa Bonito
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España.
| | | | - Ana Rodríguez Sánchez
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
| | - Elena Bermejo Marcos
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
| | - Lara Blanco Terés
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
| | - Javier García Septiem
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
| | - Elena Martín Pérez
- Servicio de Cirugía General del Hospital Universitario de La Princesa, Madrid, España
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Dworschak GC, Reutter HM, Ludwig M. Currarino syndrome: a comprehensive genetic review of a rare congenital disorder. Orphanet J Rare Dis 2021; 16:167. [PMID: 33836786 PMCID: PMC8034116 DOI: 10.1186/s13023-021-01799-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background The triad of a presacral mass, sacral agenesis and an anorectal anomaly constitutes the rare Currarino syndrome (CS), which is caused by dorsal–ventral patterning defects during embryonic development. The major causative CS gene is MNX1, encoding a homeobox protein. Main body In the majority of patients, CS occurs as an autosomal dominant trait; however, a female predominance observed, implies that CS may underlie an additional mode(s) of inheritance. Often, the diagnosis of CS is established solely by clinical findings, impacting a detailed analysis of the disease. Our combined data, evaluating more than 60 studies reporting patients with CS-associated mutations, revealed a slightly higher incidence rate in females with a female-to-male ratio of 1.39:1. Overall, MNX1 mutation analysis was successful in only 57.4% of all CS patients investigated, with no mutation detected in 7.7% of the familial and 68% of the sporadic patients. Our studies failed to detect the presence of an expressed MNX1 isoform that might explain at least some of these mutation-negative cases. Conclusion Aside from MNX1, other genes or regulatory regions may contribute to CS and we discuss several cytogenetic studies and whole-exome sequencing data that have implicated further loci/genes in its etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01799-0.
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Affiliation(s)
- Gabriel C Dworschak
- Institute of Human Genetics, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. .,Institute of Anatomy and Cell Biology, Medical Faculty, University of Bonn, 53115, Bonn, Germany. .,Department of Pediatrics, University Hospital Bonn, 53127, Bonn, Germany.
| | - Heiko M Reutter
- Institute of Human Genetics, Medical Faculty, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.,Department of Neonatology and Pediatric Intensive Care, University Hospital Bonn, 53127, Bonn, Germany
| | - Michael Ludwig
- Department of Clinical Chemistry and Clinical Pharmacology, University of Bonn, 53127, Bonn, Germany
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