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Cruz O, Caloretti V, Salvador H, Celis V, Santa-Maria V, Morales La Madrid A, Suñol M, Puerta P, Muchart J, Krauel L, Lavarino C. Synchronous choroid plexus papilloma and Wilms tumor in a girl, disclosing a Li-Fraumeni syndrome. Hered Cancer Clin Pract 2021; 19:1. [PMID: 33407742 PMCID: PMC7789227 DOI: 10.1186/s13053-020-00158-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 12/11/2020] [Indexed: 11/26/2022] Open
Abstract
Background Li-Fraumeni Syndrome (LFS) is a cancer predisposition syndrome characterized by the early-onset of multiple primary cancers which can occur at different moments (metachronous onset) or, more rarely, coincidentally (synchronous onset). Here we describe a previously unreported patient with presentation of synchronous Wilms tumor and Choroid plexus papilloma, leading to the diagnosis of a Li-Fraumeni Syndrome (LFS). Case presentation A 6-year-old girl without previous complains presented with abdominal pain. Abdominal US and MRI showed a left renal tumor with subcapsular hematoma. Due to mild headaches, the diagnostic workup included a brain MRI that unexpectedly identified a large left parietal lobe tumor. Histopathological analysis determined the diagnosis of classic Wilms tumor and choroid-plexus papilloma (CPP), respectively. Both neoplasms showed intense nuclear p53 immunostaining associated with the pathogenic TP53 mutation c.844C > T (p.Arg282Trp). Our patient and her father shared the same heterozygous germline TP53 mutation, confirming the diagnosis of familiar Li-Fraumeni syndrome in the girl. The treatment was tailored to simultaneous tumor presentations. Conclusions LFS has been associated with Choroid plexus carcinoma (CPC), but rarely with CPP as in our patient. That suggests that it may be advisable to consider the possibility of analyzing TP53 mutation, not only in all patients with CPC, but also in some patients with CPP, especially when histological or clinical evidences point out to perform this study. The dissimilar presentation of LFS among our patient’s father, not having so far any neoplasia diagnosed, while her daughter presented precociously with two simultaneous different tumors, could be related to possible effects of modifier genes on the underlying mutant p53 genotype. Supplementary Information The online version contains supplementary material available at 10.1186/s13053-020-00158-7.
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Affiliation(s)
- Ofelia Cruz
- Department of Pediatric Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Passeig Sant Joan de Deu 2, 08950, Barcelona, Spain.
| | - Victoria Caloretti
- Department of Pediatric Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Passeig Sant Joan de Deu 2, 08950, Barcelona, Spain
| | - Hector Salvador
- Department of Pediatric Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Passeig Sant Joan de Deu 2, 08950, Barcelona, Spain
| | - Veronica Celis
- Department of Pediatric Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Passeig Sant Joan de Deu 2, 08950, Barcelona, Spain
| | - Vicente Santa-Maria
- Department of Pediatric Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Passeig Sant Joan de Deu 2, 08950, Barcelona, Spain
| | - Andrés Morales La Madrid
- Department of Pediatric Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Passeig Sant Joan de Deu 2, 08950, Barcelona, Spain
| | - Mariona Suñol
- Department of Pathology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Patricia Puerta
- Department of Neurosurgery, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Jordi Muchart
- Department of Diagnostic Imaging, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Lucas Krauel
- Department of Surgery, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Cinzia Lavarino
- Laboratory of Molecular Oncology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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