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van Peer SE, Pleijte CJH, de Krijger RR, Jongmans MCJ, Kuiper RP, Lilien MR, van Grotel M, Graf N, van den Heuvel-Eibrink MM, Hol JA. Clinical and Molecular Characteristics and Outcome of Cystic Partially Differentiated Nephroblastoma and Cystic Nephroma: A Narrative Review of the Literature. Cancers (Basel) 2021; 13:cancers13050997. [PMID: 33673661 PMCID: PMC7957568 DOI: 10.3390/cancers13050997] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/23/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Although renal tumors in children are mostly solid masses, cystic renal tumors also occur. The most likely diagnoses for cystic renal tumors include cystic partially differentiated nephroblastoma and cystic nephroma. Since these tumors are rare, limited information on the treatment, clinical and molecular characteristics, and outcome is available. In this review, we aim to summarize all reported patients with cystic partially differentiated nephroblastoma and cystic nephroma. We identified 113 cystic partially differentiated nephroblastoma and 167 cystic nephroma patients. Surgery was the cornerstone of treatment for both tumor types and chemotherapy was generally not recommended. Cystic nephroma was often related to DICER1-mutations and second tumors, whereas cystic partially differentiated nephroblastoma was related to somatic hyperdiploidy, although testing was rare. The outcome for both tumors is favorable. This study provides information for treatment decisions and stresses the importance of a central review of radiology and pathology, as well as referral to a clinical geneticist. Abstract In children presenting with a predominantly cystic renal tumor, the most likely diagnoses include cystic partially differentiated nephroblastoma (CPDN) and cystic nephroma (CN). Both entities are rare and limited information on the clinical and molecular characteristics, treatment, and outcome is available since large cohort studies are lacking. We performed an extensive literature review, in which we identified 113 CPDN and 167 CN. The median age at presentation for CPDN and CN was 12 months (range: 3 weeks–4 years) and 16 months (prenatal diagnosis–16 years), respectively. No patients presented with metastatic disease. Bilateral disease occurred in both entities. Surgery was the main treatment for both. Two/113 CPDN patients and 26/167 CN patients had previous, concomitant, or subsequent other tumors. Unlike CPDN, CN was strongly associated with somatic (n = 27/29) and germline (n = 12/12) DICER1-mutations. Four CPDN patients and one CN patient relapsed. Death was reported in six/103 patients with CPDN and six/118 CN patients, none directly due to disease. In conclusion, children with CPDN and CN are young, do not present with metastases, and have an excellent outcome. Awareness of concomitant or subsequent tumors and genetic testing is important. International registration of cystic renal tumor cohorts is required to enable a better understanding of clinical and genetic characteristics.
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Affiliation(s)
- Sophie E. van Peer
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (C.J.H.P.); (R.R.d.K.); (M.C.J.J.); (R.P.K.); (M.v.G.); (M.M.v.d.H.-E.); (J.A.H.)
- Correspondence: ; Tel.: +31-88-9727-272
| | - Corine J. H. Pleijte
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (C.J.H.P.); (R.R.d.K.); (M.C.J.J.); (R.P.K.); (M.v.G.); (M.M.v.d.H.-E.); (J.A.H.)
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (C.J.H.P.); (R.R.d.K.); (M.C.J.J.); (R.P.K.); (M.v.G.); (M.M.v.d.H.-E.); (J.A.H.)
- Department of Pathology, University Medical Center Utrecht (UMCU), 3584 CX Utrecht, The Netherlands
| | - Marjolijn C. J. Jongmans
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (C.J.H.P.); (R.R.d.K.); (M.C.J.J.); (R.P.K.); (M.v.G.); (M.M.v.d.H.-E.); (J.A.H.)
- Department of Clinical Genetics, University Medical Center Utrecht (UMCU), 3584 CX Utrecht, The Netherlands
| | - Roland P. Kuiper
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (C.J.H.P.); (R.R.d.K.); (M.C.J.J.); (R.P.K.); (M.v.G.); (M.M.v.d.H.-E.); (J.A.H.)
| | - Marc R. Lilien
- Department of Pediatric Nephrology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Martine van Grotel
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (C.J.H.P.); (R.R.d.K.); (M.C.J.J.); (R.P.K.); (M.v.G.); (M.M.v.d.H.-E.); (J.A.H.)
| | - Norbert Graf
- Department of Pediatric Oncology & Hematology, Saarland University Medical Center and Saarland University Faculty of Medicine, D-66421 Homburg, Germany;
| | - Marry M. van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (C.J.H.P.); (R.R.d.K.); (M.C.J.J.); (R.P.K.); (M.v.G.); (M.M.v.d.H.-E.); (J.A.H.)
| | - Janna A. Hol
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands; (C.J.H.P.); (R.R.d.K.); (M.C.J.J.); (R.P.K.); (M.v.G.); (M.M.v.d.H.-E.); (J.A.H.)
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Réguerre Y, Golmard L, Brisse HJ, Oliver Petit I, Savagner F, Boudjemaa S, Gauthier-Villars M, Rod J, Fresneau B, Orbach D. [DICER1 constitutional pathogenic variant syndrome: Where are we in 2019?]. Bull Cancer 2019; 106:1177-1189. [PMID: 31610911 DOI: 10.1016/j.bulcan.2019.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 08/09/2019] [Accepted: 08/14/2019] [Indexed: 11/30/2022]
Abstract
Inactivating germline pathogenic variants of the DICER1 gene are responsible for a spectrum of rare diseases, which expanded a lot in recent years. The constitution of an U.S. registry with these patients and their families as well as the registration of patients in European databases of rare tumors helped to better identify diseases encountered in this syndrome but also to study its pathophysiology (major role in miRNA maturation and recently discovered functions, e.g. in genome integrity maintenance). Most encountered disorders are pediatric malignancies, mainly the pulmonary pneumoblastoma and Sertoli-Leydig tumours. However, benign pathologies such as thyroid goiters, cystic nephromas or pulmonary cystic lesions are also frequently reported. Homogeneous guidelines regimens written by the European groups working on very rare pediatric tumors are proposed but it is important to underscore that they rely on rare scientific data; therefore overall consensus remains precarious. The genetic counseling to families is still difficult due to the large observed spectrum of tumors and the incomplete penetrance. In this article, the authors update current knowledge on the DICER1 syndrome.
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Affiliation(s)
- Yves Réguerre
- Centre Hospitalo-Universitaire de Saint Denis, service d'oncologie et d'hématologie pédiatrique, 97400 La Réunion, France.
| | - Lisa Golmard
- Institut Curie, service de génétique, 75005 Paris, France
| | - Hervé J Brisse
- Institut Curie, université Paris Sciences et Lettres, département d'imagerie, 26, rue d'Ulm Paris, 75005 Paris, France
| | - Isabelle Oliver Petit
- Hôpital des enfants, unité d'endocrinologie, génétique, maladies osseuses et gynécologie de l'enfant, TSA 70034, 31059 Toulouse Cedex, France
| | - Frédérique Savagner
- Hôpital Purpan, biologie moléculaire endocrinienne, service de biochimie, IFB, TSA 40031, 31059 Toulouse cedex, France
| | - Sabah Boudjemaa
- Hôpital d'enfants Armand Trousseau-assistance publique, service d'anatomie et de cytologie pathologiques, 75012 Paris, France
| | | | - Julien Rod
- Université de Caen, département de chirurgie pédiatrique, 14000 Caen, France; Université de Caen Basse-Normandie, UFR Médecine, 14000 Caen, France
| | - Brice Fresneau
- Université Paris-Saclay, Gustave Roussy, département d'oncologie pédiatrique, 94805 Villejuif, France; Inserm, université Paris-Sud Paris-Saclay, CESP, 94805 Villejuif, France
| | - Daniel Orbach
- Institut Curie, PSL université, Centre oncologie SIREDO (Soins, innovation recherche en oncologie de l'enfant, l'adolescent et du jeune adulte), 75005 Paris, France
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Wynd E, Borzi P, Burke J. Cystic renal mass in an infant with significant family history: Answers. Pediatr Nephrol 2018; 33:1339-1340. [PMID: 29046945 DOI: 10.1007/s00467-017-3828-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 10/09/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Elsa Wynd
- Department of Nephrology, Lady Cilento Children's Hospital, South Brisbane, Queensland, 4101, Australia.
| | - Peter Borzi
- Department of Paediatric Surgery, Lady Cilento Children's Hospital, South Brisbane, Queensland, 4101, Australia
| | - John Burke
- Department of Nephrology, Lady Cilento Children's Hospital, South Brisbane, Queensland, 4101, Australia
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Dillman JR, Trout AT, Smith EA, Towbin AJ. Hereditary Renal Cystic Disorders: Imaging of the Kidneys and Beyond. Radiographics 2017; 37:924-946. [PMID: 28493804 DOI: 10.1148/rg.2017160148] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The purpose of this article is to review the hereditary renal cystic diseases that can manifest in children and adults, with specific attention to pathogenesis and imaging features. Various common and uncommon hereditary renal cystic diseases are reviewed in terms of their underlying etiology, including the involved genetic mutations and the affected proteins and cellular structures. Focus is placed on the morphologic findings in each condition and the features that distinguish one disorder from another. The two most common categories of hereditary renal cystic disease are (a) the ciliopathic disorders, which are related to mutations affecting the primary cilia (called "ciliopathies"), and (b) the phakomatoses. Autosomal dominant polycystic kidney disease, autosomal recessive polycystic kidney disease, and the "medullary cystic disease complex" are all ciliopathies but have different phenotypes. Tuberous sclerosis complex and the associated "contiguous gene syndrome," as well as von Hippel-Lindau syndrome, are phakomatoses that can manifest with cystic renal lesions but have uniquely different extrarenal manifestations. Finally, DICER1 mutations can manifest with renal cystic lesions (typically, cystic nephromas) in patients predisposed to other malignancies in the chest, ovaries, and thyroid. Although some overlap exists in the appearance of the renal cysts associated with each of these diseases, there are clear morphologic differences (eg, cyst size, location, and complexity) that are emphasized in this review. To improve patient outcomes, it is important for the radiologist to recognize the various hereditary renal cystic diseases so that a correct diagnosis is assigned and so that the patient is adequately evaluated and followed up. ©RSNA, 2017.
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Affiliation(s)
- Jonathan R Dillman
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (J.R.D., A.T.T., A.J.T.); and the Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (E.A.S.)
| | - Andrew T Trout
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (J.R.D., A.T.T., A.J.T.); and the Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (E.A.S.)
| | - Ethan A Smith
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (J.R.D., A.T.T., A.J.T.); and the Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (E.A.S.)
| | - Alexander J Towbin
- From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (J.R.D., A.T.T., A.J.T.); and the Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, Mich (E.A.S.)
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Bueno MT, Martínez-Ríos C, la Puente Gregorio AD, Ahyad RA, Villani A, Druker H, van Engelen K, Gallinger B, Aronoff L, Grant R, Malkin D, Greer MLC. Pediatric imaging in DICER1 syndrome. Pediatr Radiol 2017; 47:1292-1301. [PMID: 28474256 DOI: 10.1007/s00247-017-3875-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 02/26/2017] [Accepted: 04/20/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND DICER1 syndrome, arising from a mutation in the DICER1 gene mapped to chromosome 14q32, is associated with an increased risk of a range of benign and malignant neoplasms. OBJECTIVE To determine the spectrum of abnormalities and imaging characteristics in patients with DICER1 syndrome at a tertiary pediatric hospital. MATERIALS AND METHODS This retrospective analysis evaluated imaging in patients ≤18 years with DICER1 germline variants between January 2004 and July 2016. An imaging database search including keywords pleuropulmonary blastoma, cystic nephroma, pineoblastoma, embryonal rhabdomyosarcoma, ovarian sex cord-stromal tumor, ovarian Sertoli-Leydig cell tumor and DICER1 syndrome, was cross-referenced against the institutional Cancer Genetics Program database, excluding patients with negative/unknown DICER1 gene testing. RESULTS Sixteen patients were included (12 females; mean age at presentation: 4.2 years, range: 14 days to 17 years), with surveillance imaging encompassing the following modalities: chest X-ray and CT; abdominal, pelvic and neck US; and brain and whole-body MRI. Malignant lesions (68.8% of patients) included pleuropulmonary blastoma (5), pineoblastoma (3), ovarian Sertoli-Leydig cell tumor (1), embryonal rhabdomyosarcoma (1) and renal sarcoma (1); benign lesions (37.5% of patients) included thyroid cysts (2), thyroid nodules (2), cystic nephroma (2), renal cysts (1) and pineal cyst (1). A common lesional appearance observed across modalities and organs was defined as the "cracked windshield" sign. CONCLUSION The spectrum of DICER1-related tumors and the young age at presentation suggest early surveillance of at-risk patients is critical, while minimizing exposure to ionizing radiation.
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Affiliation(s)
- Marta Tijerin Bueno
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Claudia Martínez-Ríos
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | | | - Rayan A Ahyad
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Anita Villani
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Harriet Druker
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kalene van Engelen
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bailey Gallinger
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Laura Aronoff
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ronald Grant
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - David Malkin
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mary-Louise C Greer
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada.
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
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Abstract
Cystic nephroma is a rare, benign multicystic lesion of the kidney. This tumor occurs both in children and in adults. In children, it is highly prevalent in males; in adults, it is more frequent in women. The term “cystic nephroma” represents two apparently different entities: pediatric cystic nephroma, a benign form thought to originate from metanephric tissue, and adult cystic nephroma, considered as a lesion of mixed epithelial stromal tumor. The clinical presentation may be a palpable mass or nonspecific symptoms such as abdominal pain, hematuria, and urinary tract infections. In this review, we summarize the ultrasound imaging features of cystic nephroma and describe the characteristics of the most common renal cystic lesions and the differential diagnosis of cystic nephroma with other renal cystic lesions.
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Abstract
It has been reported that germline DICER1 mutations correlate with a distinctive human disease syndrome. Many published studies within this field have been conducted based on rare cases. We systematically searched bibliographic databases, including PubMed, Embase, and COSMIC for articles which are related to diseases covered by DICER1 syndrome. The weighted summary of mutation frequencies among patients with pleuropulmonary blastoma (PPB), cystic nephroma (CN), and Sertoli-Leydig cell tumor (SLCT) were calculated. Forty-nine eligible articles were included. In total, 72 cases with multimorbidity of DICER1 syndrome were identified. More females (n=46, 64%) presented with multimorbidity than males (n=18, 25%) and the remaining 8 patients' sex were unknown. Nineteen of 72 patients with multimorbidity suffered from another disease that was not yet included in DICER1 syndrome, which would provide potential phenotypes of DICER1 syndrome. The germline DICER1 mutation frequencies in PPB, CN, and SLCT were 66.9%, 73.2%, and 57.1%, respectively. The somatic DICER1 mutation frequencies of PPB, CN, and SLCT were 92.4%, 87.9%, and 43.3%, respectively. Majority of patients with multimorbidity of DICER1 syndrome were mutation positive individuals so that multimorbidity may suggest the possible germline mutation of these patients and their relatives.
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8
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Liu G, Sun Z, Fu Z, Ma L, Wang X. Temperature sensing and bio-imaging applications based on polyethylenimine/CaF2 nanoparticles with upconversion fluorescence. Talanta 2017; 169:181-188. [DOI: 10.1016/j.talanta.2017.03.054] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/13/2017] [Accepted: 03/17/2017] [Indexed: 01/26/2023]
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9
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Winant AJ, Schooler GR, Concepcion NDP, Lee EY. Current Updates on Pediatric Pulmonary Infections. Semin Roentgenol 2017; 52:35-42. [DOI: 10.1053/j.ro.2016.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
Dr. Louis Dehner is an internationally renowned surgical pathologist who has published multiple textbooks and has authored or co-authored nearly 400 original articles in the medical literature. While many think of him as a pediatric pathologist, he has contributed to the literature across virtually the entire breadth of surgical pathology, and the lung and pleura is no exception. This review will highlight Dr. Dehner׳s contributions to the pulmonary and pleural pathology literature in the areas of infectious disease, medical lung disease and transplant pathology, and a number of neoplasms of the lung and pleura, with the remainder of this manuscript dedicated to the still evolving story of the pleuropulmonary blastoma as the signature contribution of his long and distinguished career.
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Affiliation(s)
- Jon H Ritter
- Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 South Euclid, St. Louis, Missouri.
| | - D Ashley Hill
- Department of Pathology, Children׳s National Medical Center, Washington, DC
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Brenneman M, Field A, Yang J, Williams G, Doros L, Rossi C, Schultz KA, Rosenberg A, Ivanovich J, Turner J, Gordish-Dressman H, Stewart D, Yu W, Harris A, Schoettler P, Goodfellow P, Dehner L, Messinger Y, Hill DA. Temporal order of RNase IIIb and loss-of-function mutations during development determines phenotype in pleuropulmonary blastoma / DICER1 syndrome: a unique variant of the two-hit tumor suppression model. F1000Res 2015; 4:214. [PMID: 26925222 PMCID: PMC4712775 DOI: 10.12688/f1000research.6746.2] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 01/27/2023] Open
Abstract
Pleuropulmonary blastoma (PPB) is the most frequent pediatric lung tumor and often the first indication of a pleiotropic cancer predisposition,
DICER1 syndrome, comprising a range of other individually rare, benign and malignant tumors of childhood and early adulthood. The genetics of
DICER1-associated tumorigenesis are unusual in that tumors typically bear neomorphic missense mutations at one of five specific “hotspot” codons within the RNase IIIb domain of
DICER 1, combined with complete loss of function (LOF) in the other allele. We analyzed a cohort of 124 PPB children for predisposing
DICER1 mutations and sought correlations with clinical phenotypes. Over 70% have inherited or
de novo germline LOF mutations, most of which truncate the
DICER1 open reading frame. We identified a minority of patients who have no germline mutation, but are instead mosaic for predisposing
DICER1 mutations. Mosaicism for RNase IIIb domain hotspot mutations defines a special category of
DICER1 syndrome patients, clinically distinguished from those with germline or mosaic LOF mutations by earlier onsets and numerous discrete foci of neoplastic disease involving multiple syndromic organ sites. A final category of PBB patients lack predisposing germline or mosaic mutations and have sporadic (rather than syndromic) disease limited to a single PPB tumor bearing tumor-specific RNase IIIb and LOF mutations. We propose that acquisition of a neomorphic RNase IIIb domain mutation is the rate limiting event in
DICER1-associated
tumorigenesis, and that distinct clinical phenotypes associated with mutational categories reflect the temporal order in which LOF and RNase IIIb domain mutations are acquired during development.
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Affiliation(s)
- Mark Brenneman
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Amanda Field
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Jiandong Yang
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Gretchen Williams
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Leslie Doros
- Division of Oncology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Christopher Rossi
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Kris Ann Schultz
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Avi Rosenberg
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Jennifer Ivanovich
- Department of Surgery, Washington University Medical Center, St. Louis, MO, 63110, USA
| | - Joyce Turner
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Division of Genetics, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Heather Gordish-Dressman
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Department of Integrative Systems Biology, George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Douglas Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, 20892, USA
| | - Weiying Yu
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Division of Oncology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Anne Harris
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Peter Schoettler
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Paul Goodfellow
- College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Louis Dehner
- Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St. Louis, MO, 63110, USA
| | - Yoav Messinger
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - D Ashley Hill
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Integrative Systems Biology, George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
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Brenneman M, Field A, Yang J, Williams G, Doros L, Rossi C, Schultz KA, Rosenberg A, Ivanovich J, Turner J, Gordish-Dressman H, Stewart D, Yu W, Harris A, Schoettler P, Goodfellow P, Dehner L, Messinger Y, Hill DA. Temporal order of RNase IIIb and loss-of-function mutations during development determines phenotype in pleuropulmonary blastoma / DICER1 syndrome: a unique variant of the two-hit tumor suppression model. F1000Res 2015; 4:214. [PMID: 26925222 DOI: 10.12688/f1000research.6746.1] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2015] [Indexed: 01/05/2023] Open
Abstract
Pleuropulmonary blastoma (PPB) is the most frequent pediatric lung tumor and often the first indication of a pleiotropic cancer predisposition, DICER1 syndrome, comprising a range of other individually rare, benign and malignant tumors of childhood and early adulthood. The genetics of DICER1-associated tumorigenesis are unusual in that tumors typically bear neomorphic missense mutations at one of five specific "hotspot" codons within the RNase IIIb domain of DICER 1, combined with complete loss of function (LOF) in the other allele. We analyzed a cohort of 124 PPB children for predisposing DICER1 mutations and sought correlations with clinical phenotypes. Over 70% have inherited or de novo germline LOF mutations, most of which truncate the DICER1 open reading frame. We identified a minority of patients who have no germline mutation, but are instead mosaic for predisposing DICER1 mutations. Mosaicism for RNase IIIb domain hotspot mutations defines a special category of DICER1 syndrome patients, clinically distinguished from those with germline or mosaic LOF mutations by earlier onsets and numerous discrete foci of neoplastic disease involving multiple syndromic organ sites. A final category of PBB patients lack predisposing germline or mosaic mutations and have sporadic (rather than syndromic) disease limited to a single PPB tumor bearing tumor-specific RNase IIIb and LOF mutations. We propose that acquisition of a neomorphic RNase IIIb domain mutation is the rate limiting event in DICER1-associated tumorigenesis, and that distinct clinical phenotypes associated with mutational categories reflect the temporal order in which LOF and RNase IIIb domain mutations are acquired during development.
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Affiliation(s)
- Mark Brenneman
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Amanda Field
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Jiandong Yang
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Gretchen Williams
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Leslie Doros
- Division of Oncology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Christopher Rossi
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Kris Ann Schultz
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Avi Rosenberg
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Jennifer Ivanovich
- Department of Surgery, Washington University Medical Center, St. Louis, MO, 63110, USA
| | - Joyce Turner
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Division of Genetics, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Heather Gordish-Dressman
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Department of Integrative Systems Biology, George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Douglas Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, 20892, USA
| | - Weiying Yu
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Division of Oncology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Anne Harris
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - Peter Schoettler
- Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
| | - Paul Goodfellow
- College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Louis Dehner
- Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University Medical Center, St. Louis, MO, 63110, USA
| | - Yoav Messinger
- International Pleuropulmonary Blastoma Registry, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA
| | - D Ashley Hill
- Division of Pathology, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Center for Genetic Medicine Research, Children's Research Institute, Children's National Medical Center and the George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA.,Department of Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, 55404, USA.,Department of Integrative Systems Biology, George Washington University School of Medicine & Health Sciences, Washington, DC, 20010, USA
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Zucker EJ, Epelman M, Newman B. Perinatal Thoracic Mass Lesions: Pre- and Postnatal Imaging. Semin Ultrasound CT MR 2015; 36:501-21. [PMID: 26614133 DOI: 10.1053/j.sult.2015.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Chest masses present a common problem in the perinatal period. Advances in prenatal ultrasound, supplemented by fetal magnetic resonance imaging, now allow early detection and detailed characterization of many thoracic lesions in utero. As such, in asymptomatic infants, assessment with postnatal computed tomography or magnetic resonance imaging can often be delayed for several months until the time at which surgery is being contemplated. Bronchopulmonary malformations comprise most of the thoracic masses encountered in clinical practice. However, a variety of other pathologies can mimic their appearances or produce similar effects such as hypoplasia of a lung or both lungs. Understanding of the key differentiating clinical and imaging features can assist in optimizing prognostication and timely management.
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Affiliation(s)
- Evan J Zucker
- Department of Radiology, Stanford University School of Medicine, Lucile Packard Children's Hospital, Stanford, CA.
| | - Monica Epelman
- Department of Medical Imaging, Nemours Children's Hospital, Orlando, FL
| | - Beverley Newman
- Department of Radiology, Stanford University School of Medicine, Lucile Packard Children's Hospital, Stanford, CA
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