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Wang L, Du R, Han L, Yang R, Li Y. A new missense mutation c.1240A>G in fumarate hydratase gene leads to uterine leiomyoma associated hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome in Chinese. Transl Oncol 2024; 45:101963. [PMID: 38663218 PMCID: PMC11063639 DOI: 10.1016/j.tranon.2024.101963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/27/2024] [Accepted: 04/15/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE This study presents a detailed analysis of the clinical and genetic characteristics of uterine leiomyoma associated with Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC), combined with exploration of family history, pathology, and management procedures, supported by thorough evidence collection. METHODS Blood samples were collected from the proband, and the pathogenic variant was verified using Sanger sequencing. A comprehensive review of family history, FH deficiency pathology, FH and 2SC immunohistochemistry staining was conducted. Functional evidence was derived from clinical and genetic information, supplemented by a literature collection and mutation was reclassified based on ACMG/AMP guidelines. RESULTS The study successfully identifies a novel missense mutation (c.1240A>G; p.Lys414Glu) in exon 9 of FH, with no prior reports in existing databases. The patient's phenotype and family history, coupled with evidence collected from the literature, contribute to the preliminary determination of the variant as likely pathogenic. We also emphasize that the importance of combining FH-deficient morphology and immunohistochemical staining with 2SC for enhanced sensitivity. CONCLUSION This research adds a novel missense mutation to the repertoire of FH gene variants, emphasizing its likely pathogenic nature based on a multidimensional analysis of phenotype, family history, and literature evidence. The findings enhance our understanding of the genetic landscape associated with FH and underscore the importance of thorough characterization for accurate variant classification.
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Affiliation(s)
- Li Wang
- Department of Gynecology & Obstetrics, Liaocheng People's Hospital, School of Medicine, Liaocheng University, PR China
| | - Ran Du
- Department of Pathology, Liaocheng People's Hospital, PR China
| | - Lin Han
- Department of Pathology, Liaocheng People's Hospital, PR China
| | - Rui Yang
- Biomedical Laboratory, School of Medicine, Liaocheng University, PR China
| | - Yingxue Li
- Department of Pathology, Liaocheng People's Hospital, PR China.
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Cheng P, Xia R, Wang X. Ferroptosis: a promising target for fumarate hydratase-deficient tumor therapeutics literature review. Transl Cancer Res 2024; 13:3126-3141. [PMID: 38988939 PMCID: PMC11231789 DOI: 10.21037/tcr-24-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/24/2024] [Indexed: 07/12/2024]
Abstract
Background and Objective This review aims to investigate the ferroptosis mechanism of fumarate hydratase (FH)-related tumors for the purpose of possible treatment of tumors. Ferroptosis is an iron (Fe)-dependent form of regulated cell death caused by lipid peroxidation on the cell membrane. Studies have implicated FH in tumorigenesis. As mutations in the FH gene alter cellular metabolism and increase tumorigenesis risk, particularly in the kidneys. As most tumor cells require higher amounts of ferrous ions (Fe2+) than normal cells, they are more susceptible to ferroptosis. Recent studies have indicated that ferroptosis is inhibited the pathogenesis and progression of FH-deficient tumors by regulating lipid and iron metabolism, glutathione-glutathione peroxidase 4 (GSH-GPX4), nuclear factor-erythroid 2-related factor 2 (NRF2)/heme oxygenase-1 (HO-1) pathways. While the Fe2+ content is significantly lower in FH-deficient tumor cells, than that in normal cells. It is promising to promote ferroptosis by increasing the concentration of Fe2+ in cells to achieve the purpose of tumor treatment. Methods In this study, we searched for relevant articles on ferroptosis and FH-deficient tumors using PubMed database. Key Content and Findings FH is a tumor suppressor. A number of basic studies have shown that the loss of FH plays an important role in hereditary leiomyomas and tumors such as renal cell carcinoma, ovarian cancer, and other tumors. This type of tumor cells can through induce ferroptosis, inhibit proliferation, migration and invasion of tumor cells, increase the sensitivity of tumor cells to chemotherapy, and reverse the drug resistance through various molecular mechanisms. At present, the research on ferroptosis in FH-related tumors is still in the basic experimental stage. Conclusions This article reviews the anti-tumor effects and mechanisms of FH and ferroptosis, in order to further explore the medical value of ferroptosis in FH-related tumor therapy.
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Affiliation(s)
- Ping Cheng
- Department of Biochemistry and Molecular Biology, Health Science Center, Yangtze University, Jingzhou, China
| | - Ruohan Xia
- Department of Biochemistry and Molecular Biology, Health Science Center, Yangtze University, Jingzhou, China
| | - Xianwang Wang
- Department of Biochemistry and Molecular Biology, Health Science Center, Yangtze University, Jingzhou, China
- Shannan Maternal and Child Health Hospital, Shannan, China
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Lan X, Feng M, Lv J, Zhang L, Hu P, Wang Y, Zhang Y, Wang S, Liu C, Liu C. A 23-year bibliometric analysis of the development of global research on hereditary renal carcinoma. Front Oncol 2024; 14:1364997. [PMID: 38887238 PMCID: PMC11180816 DOI: 10.3389/fonc.2024.1364997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/13/2024] [Indexed: 06/20/2024] Open
Abstract
Objectives Medical research continues to be extensively devoted to investigating the pathogenesis and treatment approaches of hereditary renal cancer. By aspect including researchers, institutions, countries, journals, and keywords, we conduct a bibliometric analysis of the literature pertaining to hereditary renal cancer over the last 23 years. Methods From the Web of Science Core Collection, we conducted a search for publications published between January 1, 2000 and November 28, 2023. Reviews and original articles were included. Results A cumulative count of 2,194 publications met the specified criteria for inclusion. The studies of the included articles involved a collective of 2,402 institutions representing 80 countries. Notably, the United States exhibited the highest number of published documents, constituting approximately 45.49% of the total. The preeminent institution in this discipline is the National Cancer Institute (NCI), which maintains a publication volume of 8.98%. In addition to being the most prolific author (125 publications), Linehan WM's works received the highest number of citations (11,985). In a comprehensive count, 803 journals have published related articles. In the top 10 most recent occurrences were the terms "hereditary leiomyomatosis" and "fumarate hydratase." Conclusion This is the first bibliometric analysis of the literature on hereditary renal cancer. This article offers a thorough examination of the present status of investigations concerning hereditary renal cancer during the previous 23 years.
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Affiliation(s)
- Xiaopeng Lan
- Department of Urology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Mei Feng
- Department of Urology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Ji Lv
- Department of Urology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Luchen Zhang
- Department of Urology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Pengcheng Hu
- Department of Urology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Yizhen Wang
- Department of Urology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Yanhui Zhang
- Department of Urology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Shen Wang
- Department of Urology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Chunzhao Liu
- Institute of Biochemical Engineering, College of Materials Science and Engineering Qingdao University, Qingdao, China
| | - Chunlei Liu
- Department of Urology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China
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4
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Horton A, Fostier W, Winship I, Rajan N. Facial Features of Hereditary Cancer Predisposition. JCO Oncol Pract 2024:OP2300610. [PMID: 38713892 DOI: 10.1200/op.23.00610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/07/2024] [Accepted: 03/26/2024] [Indexed: 05/09/2024] Open
Abstract
In the age of telehealth medicine, an individual's facial features may provide the only physical clues signaling the presence of a heritable cancer predisposition syndrome. These syndromes include APC-associated polyposis, Birt-Hogg-Dubé syndrome, CYLD cutaneous syndrome, hereditary leiomyomatosis and renal cell cancer, multiple endocrine neoplasia, neurofibromatosis type 1, Peutz-Jeghers syndrome, PTEN hamartoma tumor syndrome, and tuberous sclerosis complex 1 and 2, among others. Correctly identifying characteristic features is important for genetic and nongenetic specialists as early detection can enable prompt intervention, improving patient outcomes. Advancements in the availability of genetic testing allow patients and their relatives to have more information about their genetic risk profile than before. These changes in clinical pathways, combined with improvements in screening and risk-reducing treatment, highlight the need to outline the cutaneous and morphologic features of high-risk cancer syndromes for clinicians. In this review, we describe the important facial features of hereditary cancer predisposition, with emphasis on diagnosis, cutaneous and extracutaneous manifestations, and screening.
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Affiliation(s)
- Ari Horton
- Genomic Medicine and Parkville Familial Cancer Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - William Fostier
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ingrid Winship
- Genomic Medicine and Parkville Familial Cancer Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | - Neil Rajan
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
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Huayanay Espinoza JL, Espinoza Figueroa JVJ, Velezmoro Díaz VE, Huanca Amesquita LS, Cruz Baca RC, Rioja Vega MA, Guelfguat M. Soft-Tissue Sarcomas of the Genitourinary Tract with Radiologic-Pathologic Correlation. Radiographics 2024; 44:e230138. [PMID: 38236750 DOI: 10.1148/rg.230138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Genitourinary tract soft-tissue sarcomas are rare neoplasms with varied pathologic and clinical features. While some of these tumors may be aggressive high-grade malignancies, others are low grade with a relatively better prognosis. Given that the grade and extent of the disease are important prognostic factors in these tumors, timely diagnosis is crucial. Unfortunately, most imaging features of these malignancies are not pathognomonic, and various histologic subtypes do not manifest with typical classic imaging features. Therefore, reliable differentiation of the various histologic tumor types is not always possible based solely on the radiologic manifestations. Imaging findings need to be considered in the context of clinical history in corroboration with radiologic-pathologic correlation. The authors discuss the specific imaging and pathologic characteristics of various genitourinary tract soft-tissue sarcomas, emphasizing diagnostic difficulties and differential diagnoses. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
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Affiliation(s)
- Jorge L Huayanay Espinoza
- From the Departments of Radiology (J.L.H.E., J.V.J.E.F., V.E.V.D.) and Pathology (L.S.H.A., R.C.C.B., M.A.R.V.), Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520 Surquillo, 15038 Lima, Peru; and Department of Radiology, Jacobi Medical Center, Bronx, NY (M.G.)
| | - Jossue V J Espinoza Figueroa
- From the Departments of Radiology (J.L.H.E., J.V.J.E.F., V.E.V.D.) and Pathology (L.S.H.A., R.C.C.B., M.A.R.V.), Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520 Surquillo, 15038 Lima, Peru; and Department of Radiology, Jacobi Medical Center, Bronx, NY (M.G.)
| | - Vanessa E Velezmoro Díaz
- From the Departments of Radiology (J.L.H.E., J.V.J.E.F., V.E.V.D.) and Pathology (L.S.H.A., R.C.C.B., M.A.R.V.), Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520 Surquillo, 15038 Lima, Peru; and Department of Radiology, Jacobi Medical Center, Bronx, NY (M.G.)
| | - Lourdes S Huanca Amesquita
- From the Departments of Radiology (J.L.H.E., J.V.J.E.F., V.E.V.D.) and Pathology (L.S.H.A., R.C.C.B., M.A.R.V.), Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520 Surquillo, 15038 Lima, Peru; and Department of Radiology, Jacobi Medical Center, Bronx, NY (M.G.)
| | - Renier C Cruz Baca
- From the Departments of Radiology (J.L.H.E., J.V.J.E.F., V.E.V.D.) and Pathology (L.S.H.A., R.C.C.B., M.A.R.V.), Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520 Surquillo, 15038 Lima, Peru; and Department of Radiology, Jacobi Medical Center, Bronx, NY (M.G.)
| | - Marco A Rioja Vega
- From the Departments of Radiology (J.L.H.E., J.V.J.E.F., V.E.V.D.) and Pathology (L.S.H.A., R.C.C.B., M.A.R.V.), Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520 Surquillo, 15038 Lima, Peru; and Department of Radiology, Jacobi Medical Center, Bronx, NY (M.G.)
| | - Mark Guelfguat
- From the Departments of Radiology (J.L.H.E., J.V.J.E.F., V.E.V.D.) and Pathology (L.S.H.A., R.C.C.B., M.A.R.V.), Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520 Surquillo, 15038 Lima, Peru; and Department of Radiology, Jacobi Medical Center, Bronx, NY (M.G.)
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Sánchez-Heras AB, Dámaso E, Castillejo A, Robledo M, Teulé A, Lázaro C, Sánchez-Martínez R, Zúñiga Á, López-Fernández A, Balmaña J, Robles L, Ramon Y Cajal T, Castillejo MI, Ibañez RP, Sevila CM, Sánchez-Mira A, Escandell I, Gómez L, Berbel P, Soto JL. Genetic and clinical characterization of a novel FH founder mutation in families with hereditary leiomyomatosis and renal cell cancer syndrome. Orphanet J Rare Dis 2024; 19:26. [PMID: 38279137 PMCID: PMC10811853 DOI: 10.1186/s13023-024-03017-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/11/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Hereditary leiomyomatosis and renal cell cancer syndrome is a rare autosomal dominant hereditary syndrome. Previously, we published the largest cohort of FH mutation carriers in Spain and observed a highly recurrent missense heterozygous variant, FH(NM_000143.4):c.1118A > G p.(Asn373Ser), in 104 individuals from 31 apparently unrelated families. Here, we aimed to establish its founder effect and characterize the associated clinical phenotype. RESULTS Haplotype analysis confirmed that families shared a common haplotype (32/38 markers) spanning 0.61-0.82 Mb, indicating this recurrent variant was inherited from a founder ancestor. Cutaneous and uterine leiomyomatosis were diagnosed in 64.6% (64/99) and 98% (50/51) of patients, respectively, and renal cell cancer was present in 10.4% (10/96). The pathogenic FH_c.1118A > G variant is a Spanish founder mutation that originated 12-26 generations ago. We estimate that the variant may have appeared between 1370 and 1720. Individuals carrying this founder mutation had similar frequency of renal cell cancer and a higher frequency of renal cysts and leiomyomas than those in other cohorts of this syndrome. CONCLUSIONS In the Spanish province of Alicante there is a high prevalence of HLRCC because of the founder mutation FH c.1118A > G; p.(Asn373Ser). The characterization of founder mutations provides accurate and specific information regarding their penetrance and expressivity. In individuals with suspected HLRCC from the province of Alicante, genetic testing by direct analysis of the founder FH c.1118A > G; p.(Asn373Ser) mutation may be a faster and more efficient diagnostic tool compared with complete gene sequencing.
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Affiliation(s)
- Ana Beatriz Sánchez-Heras
- Cancer Genetic Counselling Unit, Medical Oncology Department, Hospital General Universitario de Elche, 03203, Elche, Alicante, Spain.
| | - Estela Dámaso
- Molecular Genetics Laboratory, Hospital General Universitario de Elche, Elche, Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), FISABIO-Elche Health Department, Elche, Spain
| | - Adela Castillejo
- Molecular Genetics Laboratory, Hospital General Universitario de Elche, Elche, Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), FISABIO-Elche Health Department, Elche, Spain
| | - Mercedes Robledo
- Hereditary Endocrine Cancer, Human Cancer Genetics Programme Spanish National Cancer Centre (CNIO), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, 28029, Madrid, Spain
| | - Alexandre Teulé
- Hereditary Cancer Program, Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Catalan Institute of Oncology, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Conxi Lázaro
- Hereditary Cancer Program, Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Catalan Institute of Oncology, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Rosario Sánchez-Martínez
- Multidisciplinary Rare Disease Unit, Internal Medicine Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Ángel Zúñiga
- Clinical Genetics Unit, Hospital Politécnico y Universitario La Fe, Valencia, Spain
| | - Adrià López-Fernández
- Hereditary Cancer Genetics Group, VHIO, and Medical Oncology Department, Hospital Vall D'Hebron, Barcelona, Spain
| | - Judith Balmaña
- Hereditary Cancer Genetics Group, VHIO, and Medical Oncology Department, Hospital Vall D'Hebron, Barcelona, Spain
| | - Luis Robles
- Medical Oncology Department. Hospital 12 de Octubre, Madrid, Spain
| | - Teresa Ramon Y Cajal
- Familiar Cancer Clinic, Medical Oncology Department, Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | - M Isabel Castillejo
- Molecular Genetics Laboratory, Hospital General Universitario de Elche, Elche, Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), FISABIO-Elche Health Department, Elche, Spain
| | - Raquel Perea Ibañez
- Cancer Genetic Counselling Unit, Medical Oncology Department, Hospital General Universitario de Elche, 03203, Elche, Alicante, Spain
| | - Carmen Martínez Sevila
- Cancer Genetic Counselling Unit, Medical Oncology Department, Hospital General Universitario de Elche, 03203, Elche, Alicante, Spain
| | - Andrea Sánchez-Mira
- Molecular Genetics Laboratory, Hospital General Universitario de Elche, Elche, Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), FISABIO-Elche Health Department, Elche, Spain
| | - Inés Escandell
- Servicio de Dermatología, Hospital General Universitario de Elda, Elda, Alicante, Spain
| | - Luís Gómez
- Urology Department, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | - Pere Berbel
- Departamento de Histología y Anatomía, Facultad de Medicina, Universidad Miguel Hernández, Sant Joan d'Alacant, Alicante, Spain
| | - José Luis Soto
- Molecular Genetics Laboratory, Hospital General Universitario de Elche, Elche, Alicante, Spain
- Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), FISABIO-Elche Health Department, Elche, Spain
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Pan S, Wang J, Liu G, Zhang J, Song Y, Kong W, Zhou Y, Wu G. Factors influencing the detection rate of fumarate peak in 1H MR spectroscopy of fumarate hydratase-deficient renal cell carcinoma at 3 T MRI. Clin Radiol 2024; 79:e80-e88. [PMID: 37923625 DOI: 10.1016/j.crad.2023.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/06/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023]
Abstract
AIM To identify factors that may be associated with fumarate detection rate in 1H-magnetic resonance spectroscopy (MRS) in fumarate hydratase-deficient renal cell carcinoma (FH-RCC). MATERIALS AND MEHODS Between February 2018 and March 2022, 16 FH-RCC patients with 30 lesions underwent 1H-MRS. Detection results were classified as having a detected fumarate peak (n=12), undetected peak (n=10), or technical failure (n=8). Factors including tumour size, tumour location, treatment history, and metastasis status were collected and analysed. A Bayesian logistic regression model was applied to evaluate the association between these factors and the detection result. RESULTS Bayesian analysis demonstrated significant associations between fumarate detection results and the following factors: long-axis diameter (odds ratio [OR] of 1.64; 95% confidence interval [CI] of 1.07-2.53), short-axis diameter (OR of 1.90; 95% CI of 1.19-3.06), voxel size (OR of 2.85; 95% CI of 1.70-4.75), treatment history (OR of 0.35; 95% CI of 0.21-0.58), non-metastatic state (OR of 2.45; 95% CI of 1.48-4.06), and lymph node metastasis (OR of 0.35; 95% CI of 0.21-0.58). Technical failure results were associated with factors such as treatment history (OR of 2.59; 95% CI of 1.37-4.66), non-metastatic state (OR of 0.36; 95% CI of 0.19-0.66), and lymph node metastasis (OR of 2.61; 95% CI of 1.39-4.74). CONCLUSION Tumour size, treatment history, and metastasis character were associated with the detection of abnormal fumarate accumulation. This finding will serve as a reference for interpreting 1H-MRS results and for selecting suitable scenarios to evaluate FH-RCC.
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Affiliation(s)
- S Pan
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - J Wang
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - G Liu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - J Zhang
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Y Song
- MR Scientific Marketing, Siemens Healthineers Ltd, Shanghai, 201318, China
| | - W Kong
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
| | - Y Zhou
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
| | - G Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
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Alchoueiry M, Cornejo K, Henske EP. Kidney cancer: Links between hereditary syndromes and sporadic tumorigenesis. Semin Diagn Pathol 2024; 41:1-7. [PMID: 38008653 DOI: 10.1053/j.semdp.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/06/2023] [Indexed: 11/28/2023]
Abstract
Multiple hereditary syndromes predispose to kidney cancer, including Von Hippel-Lindau syndrome, BAP1-Tumor Predisposition Syndrome, Hereditary Papillary Renal Cell Carcinoma, Tuberous Sclerosis Complex, Birt-Hogg-Dubé syndrome, Hereditary Paraganglioma-Pheochromocytoma Syndrome, Fumarate Hydratase Tumor Predisposition Syndrome, and Cowden syndrome. In some cases, mutations in the genes that cause hereditary kidney cancer are tightly linked to similar histologic features in sporadic RCC. For example, clear cell RCC occurs in the hereditary syndrome VHL, and sporadic ccRCC usually has inactivation of the VHL gene. In contrast, mutations in FLCN, the causative gene for Birt-Hogg-Dube syndrome, are rarely found in sporadic RCC. Here, we focus on the genes and pathways that link hereditary and sporadic RCC.
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Affiliation(s)
- Michel Alchoueiry
- Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kristine Cornejo
- Pathology Department, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Elizabeth P Henske
- Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Audet SE, Koleva E, Alhameedi HN, Ashcroft S, Imran A. Unusual Cutaneous Lesions in a 53-Year-Old Female: A Potential Indicator of Underlying Renal Cell Carcinoma. Cureus 2023; 15:e48783. [PMID: 38098923 PMCID: PMC10719877 DOI: 10.7759/cureus.48783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
Hereditary leiomyomatosis and renal cell cancer (HLRCC) is a rare autosomal dominant genetic disorder resulting from mutations in the fumarate hydratase (FH) gene. It is characterised by a predisposition to cutaneous and uterine leiomyomas (fibroids) and an aggressive form of renal cell carcinoma (RCC). We report the case of a 53-year-old female who presented with an unusual rash in the context of a personal and family history of uterine leiomyomas requiring hysterectomy. A skin biopsy confirmed cutaneous leiomyomas and subsequent genetic testing demonstrated a pathogenic heterozygous mutation on exon 7 of the FH gene, confirming a diagnosis of HLRCC. Due to the recognised association with renal cell carcinoma in this syndrome, abdominal imaging was performed, which excluded RCC, and the patient was commenced on lifelong surveillance with annual abdominal magnetic resonance imaging.
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Affiliation(s)
- Samuel E Audet
- Dermatology, Mid and South Essex NHS Foundation Trust, Basildon, GBR
| | - Elena Koleva
- Dermatology, Mid and South Essex NHS Foundation Trust, Southend, GBR
| | - Hayder N Alhameedi
- Internal Medicine, Mid and South Essex NHS Foundation Trust, Southend, GBR
| | - Samuel Ashcroft
- Dermatology, Mid and South Essex NHS Foundation Trust, Basildon, GBR
| | - Ayesha Imran
- Dermatology, Mid and South Essex NHS Foundation Trust, Southend, GBR
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10
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Jin X, Cao Y, Mi K, Jiang Y, Fan Q, Shi H. Evaluation of different treatment modalities for diffuse uterine leiomyomatosis: A case series report and review of the literature. Int J Gynaecol Obstet 2023; 163:51-57. [PMID: 37014595 DOI: 10.1002/ijgo.14769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/04/2023] [Accepted: 03/15/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE To provide perspectives on preoperative diagnosis and conservative treatment for diffuse uterine leiomyomatosis (DUL). METHODS The clinical characteristics, management, and outcome of the five cases diagnosed with DUL receiving surgical treatment at Peking Union Medical College Hospital between January 2010 and December 2021 were retrospectively analyzed. RESULTS DUL is a diagnosis based on histopathology. It is a subtype of uterine leiomyoma, characterized by innumerable, poorly circumscribed hypercellular nodules of bland smooth muscle cells with no cytologic atypia diffusely involving the myometrium. Clinical manifestations, including menorrhagia, anemia, and infertility, are similar to those of typical uterine leiomyomas, making a definitive preoperative diagnosis difficult. Magnetic resonance imaging plays an important role in the pre-treatment mapping. Conservative surgery can reduce the uterine volume and improve the contour of the uterine cavity, thereby relieving symptoms of menorrhagia and improving the chance of conception. Gonadotropin-releasing hormone (GnRH) agonist therapy is of great significance for controlling vaginal bleeding, reducing uterine volume, and delaying postoperative recurrence, and can be used alone or as postoperative adjuvant therapy for conservative surgery. CONCLUSION The treatment goal for DUL patients with fertility-sparing request should not aim at complete fibroid removal. A successful pregnancy can be achieved following conservative surgery and/or GnRH agonist therapy.
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Affiliation(s)
- Xia Jin
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Disease, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Obstetrics and Gynecology, Anhui Province Maternity & Child Health Hospital, Hefei, Anhui, China
| | - Yang Cao
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Disease, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kaihua Mi
- Department of Obstetrics and Gynecology, Beijing Daxing Maternity & Child Health Care Hospital, Beijing, China
| | - Ying Jiang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qingbo Fan
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Disease, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Honghui Shi
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Disease, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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11
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Alkhrait S, Ali M, Kertowidjojo E, Romero IL, Hathaway F, Madueke-Laveaux OS. Investigating Fumarate Hydratase-Deficient Uterine Fibroids: A Case Series. J Clin Med 2023; 12:5436. [PMID: 37685503 PMCID: PMC10487707 DOI: 10.3390/jcm12175436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/27/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Uterine leiomyomas or uterine fibroids are the most common benign soft tissue tumor in reproductive-aged women. Fumarate hydratase deficient (FH-d) uterine fibroids are a rare subtype that is diagnosed only on pathologic evaluation. FH-d uterine fibroids may be the first indicator of hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome. Therefore, identifying and understanding the clinical implication and diagnosis of FH-d uterine fibroids is critical for early diagnosis of HLRCC. This case series investigates the uncommon yet significant condition of FH-d uterine fibroids. We examined the clinical manifestation, diagnostic imaging, and histopathological characteristics of FH-d uterine fibroids in five cases identified at our institution over the last ten years. All diagnoses were confirmed by pathologic evaluation after surgical treatment. Gynecologists and pathologists play a critical role in the early diagnosis of FH-d uterine fibroids and must recognize the relevant clinical and pathologic findings that raise suspicion about this diagnosis. The detection of these cases is largely dependent on the pathologist's ability to recognize unique histopathologic features. Once these characteristics are identified, it should prompt a referral to a gynecologist to consider conducting germline genetic testing. The management of FH-d uterine fibroids necessitates a multidisciplinary approach, including proper genetic screening and regular surveillance, especially for renal tumors.
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Affiliation(s)
- Samar Alkhrait
- Department of OBGYN, University of Chicago Medicine, Chicago, IL 60637, USA;
| | - Munira Ali
- College of Medicine, University of Illinois, Chicago, IL 60607, USA;
| | | | - Iris L Romero
- Department of OBGYN, University of Chicago Medicine, Chicago, IL 60637, USA;
| | - Feighanne Hathaway
- Department of Medicine, University of Chicago Medicine, Chicago, IL 60637, USA;
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12
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Schwartz JW, Peyser A, Tarrash M, Goldman RH. Fumarase Deficiency and Its Effect on Infertility: A Case Series. J Reprod Infertil 2023; 24:206-211. [PMID: 37663422 PMCID: PMC10471946 DOI: 10.18502/jri.v24i3.13277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/24/2023] [Indexed: 09/05/2023] Open
Abstract
Background Fumarase deficiency is an autosomal recessive condition characterized by severe neurologic abnormalities due to homozygous mutations in the fumarate hydratase (FH) gene. Heterozygous carriers of FH mutations have increased risk of developing uterine fibroids that can be associated with hereditary leiomyomatosis and renal cell cancer (HLRCC). The association between FH mutations and infertility remains uncertain. The objective of our study was to characterize the infertility diagnoses, treatments, and outcomes in women presenting to a fertility center who were found to be carriers of fumarase deficiency based on the presence of heterozygous FH mutations. Case Presentation A retrospective case series was conducted including 10 women presenting to an academic fertility center who were found to be FH carriers based on genetic carrier screening. Of the 9 women who were engaged in further workup, 2 had imaging results consistent with uterine fibroids. One woman underwent hysteroscopic myomectomy prior to two courses of ovulation induction with timed intercourse (OI/TIC) followed by one successful cycle of IVF. Of the remaining patients, only 1 woman successfully delivered after a cycle of ovulation induction with intrauterine insemination (OI/IUI). Other patients pursuing OI/IUI, OI/TIC, or monitored natural cycles had unsuccessful experiences. Conclusion Patients with infertility who are offered genetic testing should be screened for FH mutations, as the carriers are at risk of developing HLRCC-associated uterine fibroids, which can influence fertility and pregnancy. Additional research is needed to investigate the impacts of FH mutations on infertility.
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Affiliation(s)
- Jessica Wesley Schwartz
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, New York, USA
| | - Alexandra Peyser
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Northwell Health Fertility, North Shore University Hospital, New York, USA
| | - Miriam Tarrash
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Northwell Health Fertility, North Shore University Hospital, New York, USA
| | - Randi Heather Goldman
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hofstra University, New York, USA
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Northwell Health Fertility, North Shore University Hospital, New York, USA
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13
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John A, Spain L, Hamid AA. Navigating the Current Landscape of Non-Clear Cell Renal Cell Carcinoma: A Review of the Literature. Curr Oncol 2023; 30:923-937. [PMID: 36661719 PMCID: PMC9858145 DOI: 10.3390/curroncol30010070] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/24/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Non-clear cell renal cell carcinoma (nccRCC) is an entity comprised of a heterogeneous constellation of RCC subtypes. Genomic profiling has broadened our understanding of molecular pathogenic mechanisms unique to individual nccRCC subtypes. To date, clinical trials evaluating the use of immunotherapies and targeted therapies have predominantly been conducted in patients with clear cell histology. A comprehensive review of the literature has been undertaken in order to describe molecular pathogenic mechanisms pertaining to each nccRCC subtype, and concisely summarise findings from therapeutic trials conducted in the nccRCC space.
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Affiliation(s)
- Alexius John
- Department of Medical Oncology, Eastern Health, Melbourne, VIC 3128, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
| | - Lavinia Spain
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
| | - Anis A. Hamid
- Department of Medical Oncology, Eastern Health, Melbourne, VIC 3128, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
- Eastern Health Clinical School, Monash University, Melbourne, VIC 3128, Australia
- Department of Surgery, University of Melbourne, Melbourne, VIC 3010, Australia
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14
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Ren HM, Wang QZ, Wang JN, Hong GJ, Zhou S, Zhu JY, Li SJ. Diffuse uterine leiomyomatosis: A case report and review of literature. World J Clin Cases 2022; 10:8797-8804. [PMID: 36157811 PMCID: PMC9453368 DOI: 10.12998/wjcc.v10.i24.8797] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/24/2022] [Accepted: 07/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Diffuse uterine leiomyomatosis (DUL) is a benign uterine smooth muscle neoplasm with unknown etiology. Since DUL is rarely reported, knowledge regarding it is limited. The rate of early diagnosis is low, and DUL is often misdiagnosed as common multiple uterine leiomyomas before surgery.
CASE SUMMARY A 27-year-old patient with no sexual activity presented to the Emergency Department of our hospital complaining of heavy vaginal bleeding. She had a history of uterine fibroids and menorrhagia. Pelvic examination showed a regularly enlarged uterus, similar in size to that associated with a 4-mo pregnancy. Pelvic magnetic resonance imaging (MRI) revealed numerous multiple uterine fibroids, and a transabdominal myomectomy (TM) was performed. Intraoperative exploration revealed that the myometrium was full of myoma nodules of variable sizes. Over 50 leiomyomas were removed. The pathology report confirmed leiomyoma. The patient was discharged and received a gonadotropin-releasing hormone analog (3.75 mg) for 6 mo. Ten months after surgery, the patient presented to the hospital again for abnormal uterine bleeding. MRI showed an irregular mass with a diameter of 5.2 cm without sharp demarcation in the uterine cavity. Submucosal leiomyoma was considered first, and the patient underwent a hysteroscopic myomectomy plus hymen repair. Intraoperative exploration showed that there were several leiomyomatosis masses in the cavity. Postoperative pathological examination confirmed submucosal leiomyoma and necrotic and generative tissue. Although the menstrual cycle was still irregular, the patient did not have symptoms of menorrhagia for a period of 28 mo after the second surgery.
CONCLUSION Individuals with DUL are easily misdiagnosed due to the lack of specific manifestations of this disease. MRI is helpful for early identification and preoperative evaluation. There is currently no unified method of diagnosis. For women who want to preserve fertility, conservative surgery should be made an option. When TM is chosen, a modified new myomectomy should be considered to avoid the drawbacks of traditional TM.
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Affiliation(s)
- Hui-Min Ren
- Department of Gynecology, Zhoushan Branch Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Zhoushan 316000, Zhejiang Province, China
| | - Qing-Zhu Wang
- Department of Obstetrics and Gynecology, Ningbo Hangzhou Bay Hospital, Ningbo 315336, Zhejiang Province, China
| | - Jia-Nan Wang
- Department of Pathology, Zhoushan Branch Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Zhoushan 316000, Zhejiang Province, China
| | - Gang-Jie Hong
- Department of Gynecology, Zhoushan Branch Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Zhoushan 316000, Zhejiang Province, China
| | - Shuang Zhou
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200090, China
| | - Jun-Yan Zhu
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Shan-Ji Li
- Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
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15
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Abstract
PURPOSE OF REVIEW Recognition of skin findings associated with tumor predisposition syndromes can prompt early evaluation and surveillance and improve management. Additionally, knowing when to test and when to defer performing genetic testing can streamline management. This article reviews tumor predisposition syndromes with recently characterized skin findings and disorders for which early recognition and counseling can impact the course of disease. RECENT FINDINGS Café au lait macules (CALMs) are important in many tumor predisposition syndromes, and 'atypical' CALMs are associated with constitutional mismatch repair deficiency and Fanconi anemia. Melanoma predisposition syndromes caused by pathogenic variants in POT1 and BAP1 are more recently described, and both are associated with Spitzoid tumors. Somatic pathogenic variants can cause segmental nevoid basal cell carcinoma syndrome and a mosaic form of Peutz-Jeghers syndrome. Patients with PTEN hamartoma syndrome have increased risk for melanoma but this might not occur until adulthood. SUMMARY The cutaneous manifestations of tumor predisposition syndromes can aid diagnosis. Early photoprotection is key to modifying a main risk factor for skin cancer in many of these syndromes. Implementing surveillance guidelines facilitates early detection of tumors.
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16
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Ahvenainen T, Kaukomaa J, Kämpjärvi K, Uimari O, Ahtikoski A, Mäkinen N, Heikinheimo O, Aaltonen LA, Karhu A, Bützow R, Vahteristo P. Comparison of 2SC, AKR1B10, and FH Antibodies as Potential Biomarkers for FH-deficient Uterine Leiomyomas. Am J Surg Pathol 2022; 46:537-546. [PMID: 34678832 DOI: 10.1097/pas.0000000000001826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hereditary leiomyomatosis and renal cell cancer (HLRCC) is a tumor predisposition syndrome caused by germline fumarate hydratase (FH) mutations and characterized by uterine and cutaneous leiomyomas and renal cell cancer. Currently, there is no generally approved method to differentiate FH-deficient uterine leiomyomas from other leiomyomas. Here, we analyzed 3 antibodies (S-(2-succino)-cysteine [2SC], aldo-keto reductase family 1, member B10 [AKR1B10], and FH) as potential biomarkers. The study consisted of 2 sample series. The first series included 155 formalin-fixed paraffin-embedded uterine leiomyomas, of which 90 were from HLRCC patients and 65 were sporadic. The second series included 1590 unselected fresh frozen leiomyomas. Twenty-seven tumors were from known HLRCC patients, while the FH status for the remaining 1563 tumors has been determined by copy number analysis and Sanger sequencing revealing 45 tumors with monoallelic (n=33) or biallelic (n=12) FH loss. Altogether 197 samples were included in immunohistochemical analyses: all 155 samples from series 1 and 42 available corresponding formalin-fixed paraffin-embedded samples from series 2 (15 tumors with monoallelic and 7 with biallelic FH loss, 20 with no FH deletion). Results show that 2SC performed best with 100% sensitivity and specificity. Scoring was straightforward with unambiguously positive or negative results. AKR1B10 identified most tumors accurately with 100% sensitivity and 99% specificity. FH was 100% specific but showed slightly reduced 91% sensitivity. Both FH and AKR1B10 displayed also intermediate staining intensities. We suggest that when patient's medical history and/or histopathologic tumor characteristics indicate potential FH-deficiency, the tumor's FH status is determined by 2SC staining. When aberrant staining is observed, the patient can be directed to genetic counseling and mutation screening.
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Affiliation(s)
- Terhi Ahvenainen
- Applied Tumor Genomics Research Program
- Department of Medical and Clinical Genetics, University of Helsinki
- iCAN Digital Precision Cancer Medicine Flagship
| | - Jaana Kaukomaa
- Applied Tumor Genomics Research Program
- Department of Medical and Clinical Genetics, University of Helsinki
| | - Kati Kämpjärvi
- Applied Tumor Genomics Research Program
- Department of Medical and Clinical Genetics, University of Helsinki
| | - Outi Uimari
- Department of Obstetrics and Gynecology, Oulu University Hospital
- PEDEGO Research Unit, University of Oulu and Oulu University Hospital
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu
| | - Anne Ahtikoski
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu
- Department of Pathology, Oulu University Hospital
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland
| | - Netta Mäkinen
- Applied Tumor Genomics Research Program
- Department of Medical and Clinical Genetics, University of Helsinki
| | - Oskari Heikinheimo
- Applied Tumor Genomics Research Program
- Department of Obstetrics and Gynecology, Helsinki University Hospital
| | - Lauri A Aaltonen
- Applied Tumor Genomics Research Program
- Department of Medical and Clinical Genetics, University of Helsinki
- iCAN Digital Precision Cancer Medicine Flagship
| | - Auli Karhu
- Applied Tumor Genomics Research Program
- Department of Medical and Clinical Genetics, University of Helsinki
- iCAN Digital Precision Cancer Medicine Flagship
| | - Ralf Bützow
- Applied Tumor Genomics Research Program
- Department of Pathology, Laboratory of Helsinki University Hospital (HUSLAB), Helsinki University Hospital and University of Helsinki, Helsinki
| | - Pia Vahteristo
- Applied Tumor Genomics Research Program
- Department of Medical and Clinical Genetics, University of Helsinki
- iCAN Digital Precision Cancer Medicine Flagship
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17
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Yagi Y, Abeto N, Shiraishi J, Miyata C, Inoue S, Murakami H, Nakashima M, Sugano K, Ushiama M, Yoshida T, Yamazawa K. A novel pathogenic variant of the FH gene in a family with hereditary leiomyomatosis and renal cell carcinoma. Hum Genome Var 2022; 9:3. [PMID: 35034951 PMCID: PMC8761746 DOI: 10.1038/s41439-021-00180-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/08/2021] [Accepted: 12/13/2021] [Indexed: 01/15/2023] Open
Abstract
Hereditary leiomyomatosis and renal cell carcinoma caused by loss-of-function germline variants of the FH gene can develop into aggressive renal cell carcinoma (RCC). We report the case of a 27-year-old man who died of RCC. Genetic testing revealed a novel pathogenic variant of FH, NM_000143.3:c.1013_1014del (p.Ile338Serfs*3), that was also identified in healthy siblings. Identification of genetic causes in the proband helped us to provide relatives with precise genetic counseling and appropriate surveillance programs.
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Affiliation(s)
- Yasuto Yagi
- grid.416239.bDepartment of Urology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Naoko Abeto
- grid.416239.bDepartment of Pathology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan ,grid.272242.30000 0001 2168 5385Department of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Junichi Shiraishi
- grid.416239.bDepartment of Pathology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Chieko Miyata
- grid.416239.bDepartment of Palliative Care Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Satomi Inoue
- grid.416239.bMedical Genetics Center, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Haruka Murakami
- grid.416239.bMedical Genetics Center, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Moeko Nakashima
- grid.416239.bMedical Genetics Center, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kokichi Sugano
- Department of Genetic Medicine, Sasaki Foundation, Kyoundo Hospital, Tokyo, Japan ,grid.272242.30000 0001 2168 5385Department of Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan
| | - Mineko Ushiama
- grid.272242.30000 0001 2168 5385Department of Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan
| | - Teruhiko Yoshida
- grid.272242.30000 0001 2168 5385Department of Genetic Medicine and Services, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Yamazawa
- grid.416239.bMedical Genetics Center, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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18
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Sousa FAE, Ferreira J, Cunha TM. MR Imaging of uterine sarcomas: a comprehensive review with radiologic-pathologic correlation. Abdom Radiol (NY) 2021; 46:5687-5706. [PMID: 34468798 DOI: 10.1007/s00261-021-03263-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 02/07/2023]
Abstract
The aim of this article is to summarize the MRI features of each sarcoma subtype and to correlate them with its pathological findings. Literature review through PubMed/Medline database to identify relevant articles on uterine sarcomas, with a special emphasis on their MRI findings and pathological features. While several, more generalistic, MRI findings of a uterine tumour should raise suspicion for malignancy (including irregular contour, intra-tumoral necrosis/hemorrhage and low ADC values), some particular features may suggest their specific histological subtype such as the gross lymphovascular invasion associated with endometrial stromal sarcomas, the "bag of worms" appearance of the low-grade endometrial stromal sarcoma and the "lattice-like" aspect of adenosarcomas which results from the mixed composition of solid and multiseptated cystic components. Knowledge of the different histological uterine sarcoma subtypes, their specific MRI features and comprehension of their pathological background allows for a more confident diagnosis and may indicate the correct histological subtype.
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Affiliation(s)
- Filipa Alves E Sousa
- Department of Radiology, Centro Hospitalar Universitário de Lisboa Central, Alameda Santo António dos Capuchos, 1169-050, Lisbon, Portugal.
| | - Joana Ferreira
- Department of Pathology, Instituto Português de Oncologia de Lisboa Francisco Gentil, R. Prof. Lima Basto, 1099-023, Lisbon, Portugal
- Nova Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Teresa Margarida Cunha
- Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, R. Prof. Lima Basto, 1099-023, Lisbon, Portugal
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19
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Taniguchi R, Muramatsu H, Okuno Y, Yoshida T, Wakamatsu M, Hamada M, Shirota C, Sumida W, Hinoki A, Tainaka T, Gotoh Y, Tsuzuki T, Tanaka Y, Kojima S, Uchida H, Takahashi Y. A patient with very early onset FH-deficient renal cell carcinoma diagnosed at age seven. Fam Cancer 2021; 21:337-341. [PMID: 34156580 DOI: 10.1007/s10689-021-00268-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/13/2021] [Indexed: 12/20/2022]
Abstract
Hereditary leiomyomatosis and renal cell cancer (HLRCC) is caused by heterozygous germline variants in the fumarate hydratase (FH) gene and is associated with increased susceptibility to cutaneous leiomyomas, uterine leiomyomas, and renal cell carcinoma (RCC). HLRCC-associated RCC usually occurs in the middle age, with the median age being 40-44 years. This report describes a seven-year-old (84-month-old) male who developed a large right kidney tumor with multiple cystic lesions that contained enhanced solid components. There was no evidence of distant metastasis. The male patient underwent right nephrectomy and has been recovering well without metastasis or recurrence. Pathological examination revealed that tumor cells with relatively prominent nucleoli and surrounded by halos, were located in a limited area. Immunohistochemical staining was negative for FH. Whole-exome sequencing identified his germline variant in the FH gene and its loss of heterozygosity in the tumor. At nine years (114 months) of age, the male patient showed no recurrence of the tumor. This was the youngest-onset case of HLRCC-associated RCC to date. This report may affect the starting age for future RCC-surveillance programs for patients with HLRCC.
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Affiliation(s)
- Rieko Taniguchi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hideki Muramatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Yusuke Okuno
- Medical Genomics Center, Nagoya University Hospital, Nagoya, Japan
| | - Taro Yoshida
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Manabu Wakamatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Motoharu Hamada
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Chiyoe Shirota
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Wataru Sumida
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akinari Hinoki
- Department of Rare/ Intractable Cancer Analysis Research, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takahisa Tainaka
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshimitsu Gotoh
- Department of Pediatric Nephrology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Yukichi Tanaka
- Department of Pathology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Seiji Kojima
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hiroo Uchida
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
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20
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Zhang C, Li L, Zhang Y, Zeng C. Hereditary Leiomyomatosis and Renal Cell Cancer: Recent Insights Into Mechanisms and Systemic Treatment. Front Oncol 2021; 11:686556. [PMID: 34113573 PMCID: PMC8185197 DOI: 10.3389/fonc.2021.686556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/05/2021] [Indexed: 12/31/2022] Open
Abstract
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is a rare autosomal dominant hereditary cancer syndrome characterized by a predisposition to cutaneous leiomyomas, uterine leiomyomas, and renal cell carcinoma (RCC). It is known to be caused by germline mutations of the fumarate hydratase (FH) gene, which encodes an enzyme component of the citric acid cycle and catalyzes the conversion of fumarate to L-malate. Currently, there is no standardized treatment for HLRCC, which may be due in part to a lack of understanding of the underlying mechanisms. Here, the underlying molecular mechanisms by which the inactivation of FH causes HLRCC are discussed. Additionally, potential therapeutic pharmacological strategies are also summarized to provide new perspectives for the prevention and treatment of HLRCC.
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Affiliation(s)
- Congwang Zhang
- Department of Medical Laboratory, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Lijun Li
- Department of Quality Control, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Yipeng Zhang
- Clinical Laboratory, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Changchun Zeng
- Department of Medical Laboratory, Shenzhen Longhua District Central Hospital, Shenzhen, China
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