1
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Hol JA, Jongmans MCJ, Littooij AS, de Krijger RR, Kuiper RP, van Harssel JJT, Mensenkamp A, Simons M, Tytgat GAM, van den Heuvel-Eibrink MM, van Grotel M. Renal cell carcinoma in young FH mutation carriers: case series and review of the literature. Fam Cancer 2021; 19:55-63. [PMID: 31792767 PMCID: PMC7026215 DOI: 10.1007/s10689-019-00155-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC) is an autosomal dominant syndrome caused by heterozygous pathogenic germline variants in the fumarate hydratase (FH) gene. It is characterized by cutaneous and uterine leiomyomas and an increased risk of developing renal cell carcinoma (RCC), which is usually adult-onset. HLRCC-related RCC tends to be aggressive and can metastasize even when the primary tumor is small. Data on children and adolescents are scarce. Herein, we report two patients from unrelated Dutch families, with HLRCC-related RCC at the ages of 15 and 18 years, and a third patient with an FH mutation and complex renal cysts at the age of 13. Both RCC’s were localized and successfully resected, and careful MRI surveillance was initiated to monitor the renal cysts. One of the patients with RCC subsequently developed an ovarian Leydig cell tumor. A review of the literature identified 10 previously reported cases of HLRCC-related RCC in patients aged younger than 20 years, five of them presenting with metastatic disease. These data emphasize the importance of recognizing HLRCC in young patients to enable early detection of RCC, albeit rare. They support the recommendations from the 2014 consensus guideline, in which genetic testing for FH mutations, and renal MRI surveillance, is advised for HLRCC family members from the age of 8–10 years onwards.
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Affiliation(s)
- J A Hol
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.
| | - M C J Jongmans
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.,Department of Genetics, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - A S Littooij
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.,Department of Radiology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - R R de Krijger
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands.,Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R P Kuiper
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - J J T van Harssel
- Department of Genetics, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - A Mensenkamp
- Department of Genetics, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - M Simons
- Department of Pathology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - G A M Tytgat
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | | | - M van Grotel
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
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2
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Sánchez-Heras AB, Castillejo A, García-Díaz JD, Robledo M, Teulé A, Sánchez R, Zúñiga Á, Lastra E, Durán M, Llort G, Yagüe C, Ramon y Cajal T, López San Martin C, López-Fernández A, Balmaña J, Robles L, Mesa-Latorre JM, Chirivella I, Fonfria M, Perea Ibañez R, Castillejo MI, Escandell I, Gomez L, Berbel P, Soto JL. Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome in Spain: Clinical and Genetic Characterization. Cancers (Basel) 2020; 12:E3277. [PMID: 33167498 PMCID: PMC7694543 DOI: 10.3390/cancers12113277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 11/17/2022] Open
Abstract
Hereditary leiomyomatosis and renal cell cancer syndrome (HLRCC) is a very rare hereditary disorder characterized by cutaneous leiomyomas (CLMs), uterine leiomyomas (ULMs), renal cysts (RCys) and renal cell cancers (RCCs). We aimed to describe the genetics, clinical features and potential genotype-phenotype associations in the largest cohort of fumarate hydratase enzyme mutation carriers known from Spain using a multicentre, retrospective study of individuals with a genetic or clinical diagnosis of HLRCC. We collected clinical information from medical records, analysed genetic variants and looked for genotype-phenotype associations. Analyses were performed using R 3.6.0. software. We included 197 individuals: 74 index cases and 123 relatives. CLMs were diagnosed in 65% of patients, ULMs in 90% of women, RCys in 37% and RCC in 10.9%. Twenty-seven different pathogenic variants were detected, 12 (44%) of them not reported previously. Patients with missense pathogenic variants showed higher frequencies of CLMs, ULMs and RCys, than those with loss-of-function variants (p = 0.0380, p = 0.0015 and p = 0.024, respectively). This is the first report of patients with HLRCC from Spain. The frequency of RCCs was lower than those reported in the previously published series. Individuals with missense pathogenic variants had higher frequencies of CLMs, ULMs and RCys.
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Affiliation(s)
- A. Beatriz Sánchez-Heras
- Cancer Genetic Counselling Unit, Medical Oncology Department, Hospital General Universitario de Elche, 03203 Elche, Spain;
| | - Adela Castillejo
- Molecular Genetics Unit, Hospital General Universitario de Elche, 03203 Elche, Spain; (A.C.); (M.I.C.); (J.L.S.)
| | - Juan D. García-Díaz
- Clinical Genetics Unit, Department of Internal Medicine, University Hospital Príncipe de Asturias, 28805 Alcalá de Henares, Spain; (J.D.G.-D.); (J.M.M.-L.)
| | - Mercedes Robledo
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Center (CNIO), 28029 Madrid, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029 Madrid, Spain
| | - Alexandre Teulé
- Hereditary Cancer Program, Catalan Institute of Oncology, Instituto de Investigación Biomédica de Bellvitge, 08908 Hospitalet de Llobregat, Spain;
| | - Rosario Sánchez
- Unidad Multidisciplinar de Enfermedades de Baja Prevalencia, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitario de Alicante, 03015 Alicante, Spain;
| | - Ángel Zúñiga
- Unit of Genetics, Hospital Universitario Politécnico La Fe, 46026 Valencia, Spain;
| | - Enrique Lastra
- Unidad de Consejo Genético en Cáncer Hereditario, Servicio de Oncología Médica, Hospital Universitario de Burgos, 09006 Burgos, Spain;
| | - Mercedes Durán
- Genética del Cáncer, Instituto de Biología y Genética Molecular (IBGM-UVA-CSIC), 47003 Valladolid, Spain;
| | - Gemma Llort
- Hereditary Cancer Unit, Medical Oncology Department, Corporació Sanitaria Universitària Parc Taulí, 08208 Sabadell, Spain;
| | - Carmen Yagüe
- Hereditary Cancer Unit, Medical Oncology Department, Consorci Sanitari de Terrassa, 08191 Rubi, Spain;
| | - Teresa Ramon y Cajal
- Medical Oncology Department, Hospital Santa Creu i Sant Pau, 08091 Barcelona, Spain; (T.R.y.C.); (C.L.S.M.)
| | - Consol López San Martin
- Medical Oncology Department, Hospital Santa Creu i Sant Pau, 08091 Barcelona, Spain; (T.R.y.C.); (C.L.S.M.)
| | - Adrià López-Fernández
- Hereditary Cancer Genetics Group, Medical Oncology Department (VHIO), Hospital Universitario Vall d’Hebron, 08035 Barcelona, Spain; (A.L.-F.); (J.B.)
| | - Judith Balmaña
- Hereditary Cancer Genetics Group, Medical Oncology Department (VHIO), Hospital Universitario Vall d’Hebron, 08035 Barcelona, Spain; (A.L.-F.); (J.B.)
| | - Luis Robles
- Unidad de Cáncer Familiar, Servicio de Oncología Médica, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain;
| | - José M. Mesa-Latorre
- Clinical Genetics Unit, Department of Internal Medicine, University Hospital Príncipe de Asturias, 28805 Alcalá de Henares, Spain; (J.D.G.-D.); (J.M.M.-L.)
| | - Isabel Chirivella
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, 46010 Valencia, Spain;
| | - María Fonfria
- Cancer Genetic Counselling Unit, Medical Oncology Department, Consorcio Hospitalario Provincial de Castellón, 12002 Castellón, Spain;
| | - Raquel Perea Ibañez
- Cancer Genetic Counselling Unit, Medical Oncology Department, Hospital General Universitario de Elche, 03203 Elche, Spain;
| | - M. Isabel Castillejo
- Molecular Genetics Unit, Hospital General Universitario de Elche, 03203 Elche, Spain; (A.C.); (M.I.C.); (J.L.S.)
| | - Inés Escandell
- Servicio de Dermatología, Hospital General Universitario de Elda, 03600 Elda, Spain;
| | - Luis Gomez
- Urology Department, Hospital Universitario Sant Joan de Alicante, 03550 Sant Joan de Alicante, Spain;
| | - Pere Berbel
- Departamento de Histología y Anatomía, Facultad de Medicina, Universidad Miguel Hernández, 03550 Sant Joan de Alicante, Spain;
| | - Jose Luis Soto
- Molecular Genetics Unit, Hospital General Universitario de Elche, 03203 Elche, Spain; (A.C.); (M.I.C.); (J.L.S.)
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3
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Wyvekens N, Valtcheva N, Mischo A, Helmchen B, Hermanns T, Choschzick M, Hötker AM, Rauch A, Mühleisen B, Akhoundova D, Weber A, Moch H, Rupp NJ. Novel morphological and genetic features of fumarate hydratase deficient renal cell carcinoma in HLRCC syndrome patients with a tailored therapeutic approach. Genes Chromosomes Cancer 2020; 59:611-619. [PMID: 32537760 DOI: 10.1002/gcc.22878] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 01/09/2023] Open
Abstract
The hereditary leiomyomatosis and renal cell carcinoma syndrome (HLRCC) is defined by germline mutations in the fumarate hydratase (FH) gene and associated with leiomyomas and aggressive renal cell carcinomas with FH deficiency. Here, we comprehensively characterize two new patients with HLRCC syndrome on a morphological, immunohistochemical and genetic level. The patients developed aggressive HLRCC syndrome-associated RCCs, uterine leiomyomas and dermal leiomyomas. One HLRCC syndrome-associated RCC exhibited an unusual morphology with accumulation of "colloid-like" cytoplasmic inclusions, which might serve as a novel sentinel feature to trigger further testing. This case showed partially retained FH expression, initially hampering correct diagnosis. Comprehensive next-generation sequencing analyses of HLRCC syndrome-associated RCC and leiomyomas in our patients revealed divergent genetic changes in the FH gene in different tumors from the same patient. While all leiomyomas (uterine and cutaneous) showed a FH loss of heterozygosity (LOH) as a wildtype allele inactivating event, one HLRCC-RCC showed a second, undescribed NM_000143.3; c.947C>T; p.Ala316Val FH mutation accompanying the preexisting splice site mutation c.378+2T>C. In the other HLRCC syndrome-associated RCC, the FH mutation (NM_000143.3; c.462T>G; p.Asn154Lys with a somatic LOH) represents another variant of unknown significance that we link to HLRCC - and thus classify as likely pathogenic. Due to the specific diagnosis of metastatic HLRCC syndrome-associated RCC, both cases were treated in first line with bevacizumab/erlotinib and showed remarkable and long lasting responses. These findings allow new morphological and molecular insights into the biology of the HLRCC syndrome, corroborate the "second hit" hypothesis of tumor formation in HLRCC patients and may promote a distinct therapeutic approach.
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Affiliation(s)
- Nicolas Wyvekens
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Nadejda Valtcheva
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Axel Mischo
- Department of Hematology and Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Birgit Helmchen
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Thomas Hermanns
- Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias Choschzick
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andreas M Hötker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anita Rauch
- Institute of Medical Genetics (IMG), University of Zurich, Schlieren-Zurich, Switzerland
| | - Beda Mühleisen
- Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dilara Akhoundova
- Department of Hematology and Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Achim Weber
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Institute of Molecular Cancer Research (IMCR), University of Zurich, Zurich, Switzerland
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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4
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Feocromocitoma asociado a leiomiomatosis cutánea y uterina y cáncer renal en un paciente con una mutación germinal en el gen de la fumarato hidratasa. ENDOCRINOL DIAB NUTR 2020; 67:291-293. [DOI: 10.1016/j.endinu.2019.03.014] [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: 01/10/2019] [Revised: 03/23/2019] [Accepted: 03/25/2019] [Indexed: 11/19/2022]
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5
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Zhang L, Walsh MF, Jairam S, Mandelker D, Zhong Y, Kemel Y, Chen YB, Musheyev D, Zehir A, Jayakumaran G, Brzostowski E, Birsoy O, Yang C, Li Y, Somar J, DeLair D, Pradhan N, Berger MF, Cadoo K, Carlo MI, Robson ME, Stadler ZK, Iacobuzio-Donahue CA, Joseph V, Offit K. Fumarate hydratase FH c.1431_1433dupAAA (p.Lys477dup) variant is not associated with cancer including renal cell carcinoma. Hum Mutat 2019; 41:103-109. [PMID: 31444830 DOI: 10.1002/humu.23900] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 08/13/2019] [Accepted: 08/19/2019] [Indexed: 01/25/2023]
Abstract
Fumarate hydratase (FH) mutations underpin the autosomal recessive syndrome. FH deficiency and the autosomal dominant syndrome hereditary leiomyomatosis and renal cell carcinoma (HLRCC). The FH c.1431_1433dupAAA (p.Lys477dup) genomic alteration has been conclusively shown to contribute to FH deficiency when occurring with another FH germline alteration. However, a sufficiently large dataset has been lacking to conclusively determine its clinical significance to cancer predisposition in the heterozygous state. We reviewed a series of 7,571 patients with cancer who received germline results through MSK-IMPACT testing at the Memorial Sloan Kettering Cancer Center. The FH c.1431_1433dupAAA (p.Lys477dup) variant was detected in 24 individuals, none of whom was affected with renal cancer. Eleven of the 372 patients with renal cancer were identified to carried pathogenic FH variants associated with HLRCC. None of these 372 patients with renal cancer carried the FH c.1431_1433dupAAA variant. Our data indicate the FH c.1431_1433dupAAA is not associated with cancer including renal cell carcinoma.
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Affiliation(s)
- Liying Zhang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Michael F Walsh
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York City, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Sowmya Jairam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Diana Mandelker
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Yi Zhong
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York.,Niehaus Center for Inherited Cancer Genomics, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Yelena Kemel
- Niehaus Center for Inherited Cancer Genomics, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Ying-Bei Chen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | | | - Ahmet Zehir
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Gowtham Jayakumaran
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Edyta Brzostowski
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Ozge Birsoy
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Ciyu Yang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Yirong Li
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Joshua Somar
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Deborah DeLair
- Department of Pathology, New York University Medical Center, New York City, New York
| | - Nisha Pradhan
- University of Colorado School of Medicine, Aurora, Colorado
| | - Michael F Berger
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Karen Cadoo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York.,Department of Medicine, Weill Cornell Medical College, New York City, New York
| | - Maria I Carlo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York.,Department of Medicine, Weill Cornell Medical College, New York City, New York
| | - Mark E Robson
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York.,Department of Medicine, Weill Cornell Medical College, New York City, New York
| | - Zsofia K Stadler
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York.,Department of Medicine, Weill Cornell Medical College, New York City, New York
| | - Christine A Iacobuzio-Donahue
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York.,Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Vijai Joseph
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York.,Department of Medicine, Weill Cornell Medical College, New York City, New York
| | - Kenneth Offit
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York.,Department of Medicine, Weill Cornell Medical College, New York City, New York
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6
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Çaliskan E, Bodur S, Ulubay M, Özmen I, Çiçek AF, Deveci G, Kaya E. Hereditary leiomyomatosis and renal cell carcinoma syndrome: a case report and implications of early onset. An Bras Dermatol 2017; 92:88-91. [PMID: 29267457 PMCID: PMC5726688 DOI: 10.1590/abd1806-4841.20175380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 04/27/2016] [Indexed: 11/22/2022] Open
Abstract
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is an autosomal
dominant manifestation of cutaneous and uterine leiomyomas together with renal
cancer due to autosomal dominant germline mutations of fumarate hydratase gene.
A twenty-year-old female patient presented with type-II segmental piloleiomyoma
and increased menstruation due to uterine leiomyomas, with a history of
bilateral nephrectomy performed at 13 and 16 years of age for type 2 papillary
renal cell carcinoma. This case represents one of the very early onsets of
hereditary leiomyomatosis and renal cell carcinoma syndrome. As genetic
anticipation for renal cancer is a well-documented entity for HLRCC syndrome,
early recognition is crucial for both the patient and her family in order to
provide appropriate counseling and initiation of surveillance.
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Affiliation(s)
- Ercan Çaliskan
- Department of Dermatology, Gulhane School of Medicine - Ankara, Turkey
| | - Serkan Bodur
- Department of Obstetrics and Gynecology, Gulhane School of Medicine - Ankara, Turkey
| | - Mustafa Ulubay
- Department of Obstetrics and Gynecology, Gulhane School of Medicine - Ankara, Turkey
| | - Ibrahim Özmen
- Department of Dermatology, Çorlu State Hospital - Tekirdag, Turkey
| | - Ali Fuat Çiçek
- Department of Pathology, Gulhane School of Medicine - Ankara, Turkey
| | - Güzin Deveci
- Department of Pathology, Gulhane School of Medicine - Ankara, Turkey
| | - Engin Kaya
- Department of Urology, Gulhane School of Medicine - Ankara, Turkey
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7
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Abstract
This article provides an overview of selected genetic skin conditions where multiple inherited cutaneous tumours are a central feature. Skin tumours that arise from skin structures such as hair, sweat glands and sebaceous glands are called skin appendage tumours. These tumours are uncommon, but can have important implications for patient care. Certain appendageal tumours, particularly when multiple lesions are seen, may indicate an underlying genetic condition. These tumours may not display clinical features that allow a secure diagnosis to be made, necessitating biopsy and dermatopathological assessment. Coupled with robust clinical assessment, biopsy findings can guide genetic testing as, increasingly, the causative genes are known for these conditions. Here we review illustrative examples of appendageal tumours and relevant advances made in genetic discovery, and suggest when referral to a geneticist may need to be considered.
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Affiliation(s)
- Sarah Brown
- Institute of Genetic Medicine, Centre for Life, Newcastle upon Tyne, UK
| | - Paul Brennan
- Institute of Genetic Medicine, Centre for Life, Newcastle upon Tyne, UK
| | - Neil Rajan
- Institute of Genetic Medicine, Centre for Life, Newcastle upon Tyne, UK
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8
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Yoshinaga Y, Nakai H, Hayashi R, Ito A, Kariya N, Ito M, Shimomura Y. Novel splice site mutation in the fumarate hydratase (FH) gene is associated with multiple cutaneous leiomyomas in a Japanese patient. J Dermatol 2015; 43:85-91. [PMID: 26173633 DOI: 10.1111/1346-8138.13019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/01/2015] [Indexed: 11/29/2022]
Abstract
Cutaneous leiomyoma is a benign skin tumor that originates from the smooth muscle, such as the arrector pili muscle of the hair follicles. Familial cases with multiple cutaneous leiomyomas exist, which typically show an autosomal dominant inheritance trait. Most patients with the disease are known to carry heterozygous germ line mutations in the fumarate hydratase (FH) gene and can be complicated by tumors in internal organs, especially uterine leiomyoma and renal cell cancer in high frequency. In this study, we identified a Japanese male patient with multiple cutaneous leiomyomas and found a novel heterozygous splice site mutation, c.738 + 2T>A, in the FH gene of the patient, which was unexpectedly inherited from his unaffected father. Further analysis demonstrated loss of heterozygosity in the tumor tissue, which resulted in a hemizygote state of the mutant allele. Expression studies with the tumor tissue showed that the mutation led to skipping of exon 5 at mRNA levels, which was predicted to cause an in-frame deletion of FH protein (p.Ser186_Gln246del). The protein structure analysis strongly suggested that the deletion would severely disrupt the conformation of the FH protein including the substrate-binding domain, and thus would severely affect the expression and the function. Our findings further disclose the molecular basis of multiple cutaneous leiomyomas and also provide precious information to the mutation carriers in the family for an early diagnosis of renal cell cancer in the future.
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Affiliation(s)
- Yukina Yoshinaga
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroyuki Nakai
- Faculty of Agriculture, Niigata University, Niigata, Japan
| | - Ryota Hayashi
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akiko Ito
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoyuki Kariya
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masaaki Ito
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaka Shimomura
- Division of Dermatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Laboratory of Genetic Skin Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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9
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Collgros H, Iglesias-Sancho M, Tribó-Boixareu M, Creus-Vila L, Umbert-Millet P, Salleras-Redonnet M. Multiple Cutaneous and Uterine Leiomyomatosis or Reed Syndrome: A Retrospective Study of 13 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2014.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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10
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Collgros H, Iglesias-Sancho M, Tribó-Boixareu M, Creus-Vila L, Umbert-Millet P, Salleras-Redonnet M. Leiomiomatosis cutánea y uterina múltiple o síndrome de Reed: estudio retrospectivo de 13 casos. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:117-25. [DOI: 10.1016/j.ad.2014.08.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 08/06/2014] [Accepted: 08/28/2014] [Indexed: 11/15/2022] Open
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11
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Malik K, Patel P, Chen J, Khachemoune A. Leiomyoma cutis: a focused review on presentation, management, and association with malignancy. Am J Clin Dermatol 2015; 16:35-46. [PMID: 25605645 DOI: 10.1007/s40257-015-0112-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Cutaneous leiomyomas (CLs) are rare, sporadic, or inherited tumors of smooth muscle origin associated with various disorders. Hereditary leiomyomatosis and renal cell cancer (HLRCC) is the primary tumor predisposition syndrome associated with inherited CLs, affecting 180 families worldwide, with significant mortality. CLs are subdivided into piloleiomyomas, genital leiomyomas, and angioleiomyomas based on their smooth muscle of origin, as well as their clinicopathologic features. Piloleiomyomas, derived from arrector pili muscle, are solitary or multiple firm papulonodules located typically on the extremities and trunk; genital leiomyomas, derived from dartoic, vulvar, or mammary smooth muscle, are solitary papulonodules or pedunculated papules located on the scrotum, vulva, or nipple; and angioleiomyomas, which include solid, cavernous, or venous subtypes, are derived from the tunica media of small arteries and veins and typically present on the extremities. Partial/excisional biopsy is required for diagnosing all CLs. Histology shows interlacing fascicles of spindle cells with moderate amounts of eosinophilic cytoplasm and a blunt-ended, elongated nucleus with perinuclear halos. Surgical excision is curative for CLs, with other management options including medical or destructive therapy; active surveillance is advised to monitor HLRCC-associated neoplasms, with pharmacological therapies under active research.
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Reyes C, Karamurzin Y, Frizzell N, Garg K, Nonaka D, Chen YB, Soslow RA. Uterine smooth muscle tumors with features suggesting fumarate hydratase aberration: detailed morphologic analysis and correlation with S-(2-succino)-cysteine immunohistochemistry. Mod Pathol 2014; 27:1020-7. [PMID: 24309325 PMCID: PMC4048336 DOI: 10.1038/modpathol.2013.215] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 09/30/2013] [Accepted: 10/01/2013] [Indexed: 12/01/2022]
Abstract
Rare, sporadic uterine leiomyomas arise in the setting of severe metabolic aberration due to a somatic fumarate hydratase mutation. Germline mutations account for the hereditary leiomyomatosis and renal cell carcinoma syndrome, which predisposes for cutaneous and uterine leiomyomas and aggressive renal cell carcinomas. Altered fumarate hydratase leads to fumarate accumulation in affected cells with formation of S-(2-succino)-cysteine, which can be detected with the polyclonal antibody. High levels of these modified cysteine residues are found characteristically in fumarate hydratase-deficient cells but not in normal tissues or tumors unassociated with hereditary leiomyomatosis and renal cell carcinoma syndrome. We hypothesized that S-(2-succino)-cysteine-positive leiomyomas, indicating fumarate hydratase aberration, have morphologic features that differ from those without S-(2-succino)-cysteine positivity. Hematoxylin and eosin-stained slides of uterine smooth-muscle tumors were prospectively analyzed for features suggesting hereditary leiomyomatosis and renal cell carcinoma syndrome, such as prominent eosinophilic macronucleoli with perinucleolar halos, yielding nine cases. Germline genetic testing for fumarate hydratase mutations was performed in three cases. A detailed morphological analysis was undertaken, and S-(2-succino)-cysteine immunohistochemical analysis was performed with controls from a tissue microarray (leiomyomas (19), leiomyosarcomas (29), and endometrial stromal tumors (15)). Of the nine study cases, four had multiple uterine smooth muscle tumors. All cases had increased cellularity, staghorn vasculature, and fibrillary cytoplasm with pink globules. All cases had inclusion-like nucleoli with perinuclear halos (7 diffuse, 1 focal). All showed diffuse granular cytoplasmic labeling with the S-(2-succino)-cysteine antibody. Two of three tested patients had germline fumarate hydratase mutations. Only one leiomyoma from the tissue microarray controls was immunohistochemically positive, and it showed features similar to other immunohistochemically positive cases. Smooth-muscle tumors with fumarate hydratase aberration demonstrate morphological reproducibility across cases and S-(2-succino)-cysteine immuno-positivity. Although the features described are not specific for the germline fumarate hydratase mutation or the hereditary leiomyomatosis and renal cell carcinoma syndrome, their presence should suggest fumarate hydratase aberration. Identifying these cases is an important step in the diagnostic workup of patients with possible hereditary leiomyomatosis and renal cell carcinoma.
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Affiliation(s)
- Carolina Reyes
- Department of Pathology, Memorial-Sloan Kettering Cancer Center New York, NY
| | - Yevgeniy Karamurzin
- Department of Pathology, Memorial-Sloan Kettering Cancer Center New York, NY
| | - Norma Frizzell
- Department of Pharmacology, Physiology & Neuroscience, School of Medicine, University of South Carolina, Columbia, SC
| | - Karuna Garg
- Department of Pathology, Memorial-Sloan Kettering Cancer Center New York, NY
| | - Daisuke Nonaka
- Department of Histopathology, The Christie Hospital, and Institute of Cancer Sciences, The University of Manchester, Manchester, UK
| | - Ying-Bei Chen
- Department of Pathology, Memorial-Sloan Kettering Cancer Center New York, NY
| | - Robert A. Soslow
- Department of Pathology, Memorial-Sloan Kettering Cancer Center New York, NY
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Kudligi C, Khaitan BK, Bhagwat PV, Asati DP. Unilateral multi-segmental leiomyomas: a report of rare case. Indian J Dermatol 2013; 58:160. [PMID: 23716833 PMCID: PMC3657243 DOI: 10.4103/0019-5154.108086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A 30-year-old female presented to us with multiple tender erythematous papules and nodules. These lesions showed multi-segmental distribution along 5(th) cervical, 6(th) dorsal, and 1(st) sacral segments of right half of the body. Histopathological examination confirmed the clinical diagnosis of leiomyoma. Patient was started on nifedipine 10 mg thrice-daily with significant symptomatic improvement in 3 months. Though segmental distribution of leiomyoma is common, unilateral multi-segmental distribution has not been so far reported in the literature. Hence, the case is being reported for its rare presentation and the need for long-term follow-up in view of its association with aggressive renal carcinoma.
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Affiliation(s)
- Chandramohan Kudligi
- Department of Skin and STD, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
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14
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Messeguer F, Llombart B, Requena C, Agusti-Mejias A, Traves V, Guillen C. Coalescence of multiple piloleiomyomas in an indurated hemifacial plaque. Int J Dermatol 2013; 52:765-7. [PMID: 23679887 DOI: 10.1111/j.1365-4632.2011.05038.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Dilek N, Yüksel D, Sehitoğlu I, Saral Y. Cutaneous leiomyoma in a child: A case report. Oncol Lett 2013; 5:1163-1164. [PMID: 23599756 PMCID: PMC3629131 DOI: 10.3892/ol.2013.1194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 12/21/2012] [Indexed: 11/06/2022] Open
Abstract
Leiomyoma is a benign tumour commonly encountered in the genitourinary and gastrointestinal organs in adults. Cutaneous leiomyomas are rare benign tumors arising from the arrector pili muscle of hair follicles. Cutaneous leiomyomas are more likely to occur in adults than in children. We describe a case of a 10-year-old female who presented with multiple, firm, red-brown masses on the back. A punch biopsy was performed. Under high-power examination, spindle cells with an eosinophilic cytoplasm were observed and immunohistochemical studies were performed; the cells stained strongly positive for smooth muscle actin (SMA). The patient was subsequently diagnosed with pilar leiomyoma and referred to a plastic surgeon for surgical treatment. Although cutaneous leiomyoma is a rare disorder, we identified a case of pilar leiomyoma in a young female. A careful clinical assessment led to the correct diagnosis and therapy in the present case. We propose that leiomyoma ought to be considered in the differential diagnosis of any cutaneous or mucosal mass in children.
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Affiliation(s)
- Nursel Dilek
- Departments of Dermatology, Recep Tayyip Erdoğan University Medical Faculty Hospital, Rize 53000, Turkey
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Braun SA, Hanneken S, Reifenberger J, Helbig D, Frank J. [Hereditary cutaneous leiomyomatosis]. Hautarzt 2012; 63:276-8. [PMID: 22456612 DOI: 10.1007/s00105-012-2357-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The occurrence of multiple cutaneous leiomyomas can be indicative of hereditary cutaneous leiomyomatosis. This autosomal dominant disorder is due to germline mutations in the fumarate hydratase (FH) gene. Associations with uterine myomas and renal cell carcinomas have been described and are referred to as Multiple Cutaneous and Uterine Leiomyomas (MCUL) or Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC), respectively. A 34-year-old man presented with multiple red-brown papules and nodules. After histopathologic confirmation of piloleiomyomas, we made the diagnosis of hereditary cutaneous leiomyomatosis. Taking into consideration the aforementioned complications, close interdisciplinary management of these patients and regular screening examinations within affected families are mandatory.
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Affiliation(s)
- S A Braun
- Hautklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
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17
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Picaud S, Kavanagh KL, Yue WW, Lee WH, Muller-Knapp S, Gileadi O, Sacchettini J, Oppermann U. Structural basis of fumarate hydratase deficiency. J Inherit Metab Dis 2011; 34:671-6. [PMID: 21445611 PMCID: PMC3109261 DOI: 10.1007/s10545-011-9294-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 01/27/2011] [Accepted: 01/31/2011] [Indexed: 01/08/2023]
Abstract
Fumarate hydratase catalyzes the stereospecific hydration across the olefinic double bond in fumarate leading to L-malate. The enzyme is expressed in mitochondrial and cytosolic compartments, and participates in the Krebs cycle in mitochondria, as well as in regulation of cytosolic fumarate levels. Fumarate hydratase deficiency is an autosomal recessive trait presenting as metabolic disorder with severe encephalopathy, seizures and poor neurological outcome. Heterozygous mutations are associated with a predisposition to cutaneous and uterine leiomyomas and to renal cancer. The crystal structure of human fumarate hydratase shows that mutations can be grouped into two distinct classes either affecting structural integrity of the core enzyme architecture, or are localized around the enzyme active site. An interactive version of this manuscript (which may contain additional mutations appended after acceptance of this manuscript) may be found on the SSIEM website at: http://www.ssiem.org/resources/structures/FH .
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Affiliation(s)
- Sarah Picaud
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Kathryn L. Kavanagh
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Wyatt W. Yue
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Wen Hwa Lee
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Susanne Muller-Knapp
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - Opher Gileadi
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
| | - James Sacchettini
- Department of Biochemistry & Biophysics, Texas A&M University, College Station, TX 77843-2128 USA
| | - Udo Oppermann
- Structural Genomics Consortium, University of Oxford, Old Road Campus, Headington, OX3 7DQ UK
- Botnar Research Center, NIHR Oxford Biomedical Research Unit, Oxford, OX3 7LD UK
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Smit DL, Mensenkamp AR, Badeloe S, Breuning MH, Simon MEH, van Spaendonck KY, Aalfs CM, Post JG, Shanley S, Krapels IPC, Hoefsloot LH, van Moorselaar RJA, Starink TM, Bayley JP, Frank J, van Steensel MAM, Menko FH. Hereditary leiomyomatosis and renal cell cancer in families referred for fumarate hydratase germline mutation analysis. Clin Genet 2011; 79:49-59. [PMID: 20618355 DOI: 10.1111/j.1399-0004.2010.01486.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Heterozygous fumarate hydratase (FH) germline mutations cause hereditary leiomyomatosis and renal cell cancer (HLRCC), an autosomal dominant syndrome characterized by multiple cutaneous piloleiomyomas, uterine leiomyomas and papillary type 2 renal cancer. The main objective of our study was to evaluate clinical and genetic data from families suspected of HLRCC on a nationwide level. All families referred for FH mutation analysis in the Netherlands were assessed. We performed FH sequence analysis and multiplex ligation-dependent probe amplification. Families with similar FH mutations were examined for haplotype sharing. In 14 out of 33 families, we identified 11 different pathogenic FH germline mutations, including 4 novel mutations and 1 whole-gene deletion. Clinical data were available for 35 FH mutation carriers. Cutaneous leiomyomas were present in all FH mutation carriers older than 40 years of age. Eleven out of 21 female FH mutation carriers underwent surgical treatment for symptomatic uterine leiomyomas at an average of 35 years. Two FH mutation carriers had papillary type 2 renal cancer and Wilms' tumour, respectively. We evaluated the relevance of our findings for clinical practice and have proposed clinical diagnostic criteria, indications for FH mutation analysis and recommendations for management.
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Affiliation(s)
- D L Smit
- Department of Clinical Genetics, VU University Medical Centre, Amsterdam, The Netherlands
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Lehtonen HJ. Hereditary leiomyomatosis and renal cell cancer: update on clinical and molecular characteristics. Fam Cancer 2011; 10:397-411. [PMID: 21404119 DOI: 10.1007/s10689-011-9428-z] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Heli J Lehtonen
- Department of Medical Genetics, Genome-Scale Biology Research Program, Biomedicum Helsinki, Haartman Institute, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, Helsinki 00290, Finland.
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Kaliyadan F, Manoj J, Dharmaratnam AD. Multiple cutaneous leiomyomas: pain relief with pulsed hysocine butyl bromide. Indian J Dermatol 2010; 54:72-4. [PMID: 20049277 PMCID: PMC2800879 DOI: 10.4103/0019-5154.48994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A 35-year-old male patient presented to our outpatient department, complaining of multiple, raised skin lesions on the forehead and back, associated with intermittent pain, especially on exposure to cold. A diagnosis of cutaneous leiomyoma (type 2 segmental) was made, which was confirmed by skin biopsy. The patient was started on a trial of pulsed Hyoscine Butyl bromide tablets, following which the patient had significant relief from pain associated with the lesions.
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Affiliation(s)
- Feroze Kaliyadan
- Department of Dermatology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
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22
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Buitrago WF, Yang DJ, Coleman NM, Hsu S. JAAD Grand Rounds quiz. Multiple skin-colored papules on the flank. J Am Acad Dermatol 2010; 62:168-170. [PMID: 20082905 DOI: 10.1016/j.jaad.2008.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Revised: 10/10/2008] [Accepted: 10/18/2008] [Indexed: 10/20/2022]
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23
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Vahteristo P, Koski TA, Näätsaari L, Kiuru M, Karhu A, Herva R, Sallinen SL, Vierimaa O, Björck E, Richard S, Gardie B, Bessis D, Van Glabeke E, Blanco I, Houlston R, Senter L, Hietala M, Aittomäki K, Aaltonen LA, Launonen V, Lehtonen R. No evidence for a genetic modifier for renal cell cancer risk in HLRCC syndrome. Fam Cancer 2009; 9:245-51. [DOI: 10.1007/s10689-009-9312-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Koski TA, Lehtonen HJ, Jee KJ, Ninomiya S, Joosse SA, Vahteristo P, Kiuru M, Karhu A, Sammalkorpi H, Vanharanta S, Lehtonen R, Edgren H, Nederlof PM, Hietala M, Aittomäki K, Herva R, Knuutila S, Aaltonen LA, Launonen V. Array comparative genomic hybridization identifies a distinct DNA copy number profile in renal cell cancer associated with hereditary leiomyomatosis and renal cell cancer. Genes Chromosomes Cancer 2009; 48:544-51. [DOI: 10.1002/gcc.20663] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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25
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de Wijn RS, Zaal LH, Hennekam RCM, van der Horst CMAM. Familial clustering of giant congenital melanocytic nevi. J Plast Reconstr Aesthet Surg 2009; 63:906-13. [PMID: 19464972 DOI: 10.1016/j.bjps.2009.02.090] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2008] [Revised: 11/30/2008] [Accepted: 02/14/2009] [Indexed: 01/19/2023]
Abstract
Giant congenital melanocytic nevus (GCMN) is an infrequently occurring congenital malformation. GCMN generally occurs in isolation but rare familial occurrence points to a genetic background. We present two cases of familial GCMN: one with two affected siblings and another with two affected double second cousins. Familial occurrence of GCMN reported in literature is reviewed and an overview of the embryology and proliferation given, illustrating the plethora of factors that might lead to GCMN formation. The pattern of inheritance is likely not Mendelian and discordance in identical twins and the segmental distribution of lesions suggest a post-zygotic mutation. A polygenic paradominant inheritance best explains the clinically observed transmission pattern. Candidate genes include those influencing neural crest development and melanocyte proliferation.
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Affiliation(s)
- Robert S de Wijn
- Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Centre, University of Amsterdam, The Netherlands.
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Wilms tumour as a possible early manifestation of hereditary leiomyomatosis and renal cell cancer? Br J Dermatol 2009; 160:707-9. [DOI: 10.1111/j.1365-2133.2008.09000.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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van Steensel MAM, van Geel M, Badeloe S, Poblete-Gutiérrez P, Frank J. Molecular pathways involved in hair follicle tumor formation: all about mammalian target of rapamycin? Exp Dermatol 2009; 18:185-91. [DOI: 10.1111/j.1600-0625.2008.00808.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
A 53-year-old Chinese man presented with a history of painful lesions on the chest of 20 years' duration. He experienced sharp pain especially on touching and after spicy food. The lesions were stable with no increase in size or number. He was otherwise well. There was no significant family history. Physical examination revealed multiple, grouped, pink papules on the left chest, extending to the right back in a segmental distribution, each measuring 2-5 mm (Figs 1 and 2). They appeared pearly and keloid-like, and had a firm consistency. A punch biopsy specimen was obtained and sent for histopathologic examination (Figs 3 and 4). This revealed a circumscribed, nonencapsulated tumor with a Grenz zone below the epidermis. It was composed of interlacing fascicles of bland spindle cells with elongated nuclei and blunt ends, typical of a cutaneous leiomyoma. The patient subsequently underwent computed tomography of the abdomen, which did not show any renal or abdominal masses.
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Affiliation(s)
- Min-Wee Chia
- Division of Dermatology, Changi General Hospital, and National Skin Centre, Singapore.
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Badeloe S, van Geest AJ, van Marion AMW, Frank J. Absence offumarate hydratasemutation in a family with cutaneous leiomyosarcoma and renal cancer. Int J Dermatol 2008; 47 Suppl 1:18-20. [DOI: 10.1111/j.1365-4632.2008.03952.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Ahvenainen T, Lehtonen HJ, Lehtonen R, Vahteristo P, Aittomäki K, Baynam G, Dommering C, Eng C, Gruber SB, Grönberg H, Harvima R, Herva R, Hietala M, Kujala M, Kääriäinen H, Sunde L, Vierimaa O, Pollard PJ, Tomlinson IPM, Björck E, Aaltonen LA, Launonen V. Mutation screening of fumarate hydratase by multiplex ligation-dependent probe amplification: detection of exonic deletion in a patient with leiomyomatosis and renal cell cancer. ACTA ACUST UNITED AC 2008; 183:83-8. [PMID: 18503824 DOI: 10.1016/j.cancergencyto.2008.01.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Revised: 01/18/2008] [Accepted: 01/24/2008] [Indexed: 11/26/2022]
Abstract
Hereditary leiomyomatosis and renal cell cancer (HLRCC) is a syndrome predisposing to cutaneous and uterine leiomyomatosis as well as renal cell cancer and uterine leiomyosarcoma. Heterozygous germline mutations in the fumarate hydratase (FH, fumarase) gene are known to cause HLRCC. On occasion, no FH mutation is detected by direct sequencing, despite the evident HLRCC phenotype in a family. In the present study, to investigate whole gene or exonic deletions and amplifications in FH mutation-negative patients, we used multiplex ligation-dependent probe amplification technology. The study material comprised 7 FH mutation-negative HLRCC patients and 12 patients affected with HLRCC-associated phenotypes, including papillary RCC, early-onset RCC, uterine leiomyomas, or uterine leiomyosarcoma. A novel FH mutation, a deletion of FH exon 1 that encodes the mitochondrial signal peptide, was detected in one of the HLRCC patients (1/7). The patient with the FH mutation displayed numerous painful cutaneous leiomyomas and papillary type renal cell cancer. Our finding, together with the two patients with whole FH gene deletion who had been detected previously, suggests that exonic or whole-gene FH deletions are not a frequent cause of HLRCC syndrome.
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Affiliation(s)
- Taru Ahvenainen
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, PO Box 63, FI-00014 Helsinki, Finland
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Badeloe S, Bladergroen RS, Jonkman MF, Burrows NP, Steijlen PM, Poblete-Gutiérrez P, van Steensel MA, van Geel M, Frank J. Hereditary multiple cutaneous leiomyoma resulting from novel mutations in the fumarate hydratase gene. J Dermatol Sci 2008; 51:139-43. [DOI: 10.1016/j.jdermsci.2008.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 04/04/2008] [Accepted: 04/09/2008] [Indexed: 10/22/2022]
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32
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[Familial cutaneous and uterine leiomyomatosis]. Ann Dermatol Venereol 2008; 135:612-6. [PMID: 18789302 DOI: 10.1016/j.annder.2008.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Accepted: 04/02/2008] [Indexed: 11/20/2022]
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33
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Makino T, Nagasaki A, Furuichi M, Matsui K, Watanabe H, Sawamura D, Shimizu H, Shimizu T. Novel mutation in a fumalate hydratase gene of a Japanese patient with multiple cutaneous and uterine leiomyomatosis. J Dermatol Sci 2007; 48:151-3. [PMID: 17768033 DOI: 10.1016/j.jdermsci.2007.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 07/18/2007] [Accepted: 07/21/2007] [Indexed: 11/21/2022]
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