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Carli D, De Pellegrin M, Franceschi L, Zinali F, Paonessa M, Spolaore S, Cardaropoli S, Cravino M, Marcucci L, Andreacchio A, Resta N, Ferrero GB, Mussa A. Evolution over Time of Leg Length Discrepancy in Patients with Syndromic and Isolated Lateralized Overgrowth. J Pediatr 2021; 234:123-127. [PMID: 33465347 DOI: 10.1016/j.jpeds.2021.01.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To provide information on evolution over time of leg length discrepancy in patients with syndromic and isolated lateralized overgrowth. STUDY DESIGN This retrospective study investigates leg length discrepancy longitudinally in 105 patients with lateralized overgrowth either isolated (n = 37) or associated with Beckwith-Wiedemann spectrum (n = 56) or PIK3CA-related overgrowth spectrum (n = 12). Discrepancy was measured by standard methods and categorized as minor, mild, severe, and critical, based on the thresholds of 1, 2 and 5, respectively. RESULTS The period of observation from diagnosis was 1.7 ± 2.6 to 9.0 ± 6.0 years. Leg length discrepancy was 11.0 ± 7.2 mm at diagnosis and 17.1 ± 14.4 mm at last visit. Both final leg length discrepancy and change over time were correlated with discrepancy at diagnosis (r2 = 0.45, P < .001 and r2 = 0.05, P = .019, respectively). Among minor leg length discrepancy at diagnosis, 47.5% remained minor, 40.0% become mild, and 12.5% severe. Among patients with discrepancy classified as severe at diagnosis, 84.6% remained severe and 15.4% evolved to critical. The isolated lateralized overgrowth group showed a milder evolution over time compared with Beckwith-Wiedemann spectrum and PIK3CA-related overgrowth spectrum groups. Among patients with Beckwith-Wiedemann, those with paternal chromosome 11 uniparental disomy had more severe leg length discrepancy at diagnosis and evolution over time. CONCLUSIONS Leg length discrepancy associated with isolated or syndromic lateralized overgrowth tends to worsen with growth and correlates with discrepancy at first observation. Among the genotypic groups, isolated lateralized overgrowth tends to have a milder evolution, whereas Beckwith-Wiedemann spectrum predisposes to a more severe outcome, especially if associated with paternal chromosome 11 uniparental disomy genotype.
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Affiliation(s)
- Diana Carli
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
| | | | - Luisa Franceschi
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
| | - Federica Zinali
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
| | - Matteo Paonessa
- Pediatric Orthopedic and Traumatology Unit, Department of Children Health and Cure, Regina Margherita Children Hospital, Città della Salute e della Scienza di Torino, Torino, Italy
| | - Simone Spolaore
- Pediatric Orthopedic and Traumatology Unit, Department of Children Health and Cure, Regina Margherita Children Hospital, Città della Salute e della Scienza di Torino, Torino, Italy
| | - Simona Cardaropoli
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy
| | - Mattia Cravino
- Pediatric Orthopedic and Traumatology Unit, Department of Children Health and Cure, Regina Margherita Children Hospital, Città della Salute e della Scienza di Torino, Torino, Italy
| | - Lorenzo Marcucci
- Pediatric Orthopedic and Traumatology Unit, San Raffaele Hospital, Milan, Italy
| | | | - Nicoletta Resta
- Medical Genetics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari Aldo Moro, Bari, Italy
| | - Giovanni Battista Ferrero
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy; Pediatric Clinical Genetics Unit, Department of Children Health and Cure, Regina Margherita Children Hospital, Città della Salute e della Scienza di Torino, Torino, Italy
| | - Alessandro Mussa
- Department of Public Health and Pediatric Sciences, University of Torino, Torino, Italy; Pediatric Clinical Genetics Unit, Department of Children Health and Cure, Regina Margherita Children Hospital, Città della Salute e della Scienza di Torino, Torino, Italy.
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Sudduth CL, Konczyk DJ, Al-Ibraheemi A, Smits PJ, Greene AK. Lipoblastoma phenotype contains a somatic PIK3CA mutation. Pediatr Dermatol 2021; 38:299-300. [PMID: 33034408 DOI: 10.1111/pde.14406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/01/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022]
Abstract
Lipoblastoma typically occurs in childhood and is associated with rearrangements of the PLAG1 gene. We present a patient with an isolated mass thought to be a lipoblastoma clinically, radiographically, and histologically. The lesion was diagnosed as a PIK3CA-adipose lesion after the tissue was negative for PLAG1 rearrangement and contained a somatic PIK3CA mutation (H1047R). Although PIK3CA variants are associated with PROS (PIK3CA-related overgrowth spectrum), this report illustrates a non-syndromic, lipoblastoma phenotype caused by a PIK3CA mutation.
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Affiliation(s)
- Christopher L Sudduth
- Department of Plastic and Oral Surgery, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Dennis J Konczyk
- Department of Plastic and Oral Surgery, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Alyaa Al-Ibraheemi
- Department of Pathology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Patrick J Smits
- Department of Plastic and Oral Surgery, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Arin K Greene
- Department of Plastic and Oral Surgery, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
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