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Chan MCY, Fung KKF, Ng WF, Luk HM, Ku DTL, Liu APY. Case report: Treatment response of NF-1-associated bladder ganglioneuroma to trametinib. Front Oncol 2024; 14:1433073. [PMID: 39070150 PMCID: PMC11272527 DOI: 10.3389/fonc.2024.1433073] [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: 05/15/2024] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
We present the clinical course of a 4-year-old girl with neurofibromatosis type 1-associated, unresectable, symptomatic urinary bladder ganglioneuroma. She was initially trialed on sirolimus without response and subsequently responded to MEK inhibitor trametinib, with improvement clinically and radiographically over 10 months. This report broadens the repertoire of therapeutic strategies for MEK inhibition in diseases related to the MAPK pathway.
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Affiliation(s)
- Marcus C. Y. Chan
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
| | - Kevin K. F. Fung
- Department of Radiology, Hong Kong Children’s Hospital, Hong Kong, Hong Kong SAR, China
| | - Wai-Fu Ng
- Department of Pathology, Hong Kong Children’s Hospital, Hong Kong, Hong Kong SAR, China
| | - Ho-Ming Luk
- Clinical Genetics Service Unit, Hong Kong Children’s Hospital, Hong Kong, Hong Kong SAR, China
| | - Dennis T. L. Ku
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, Hong Kong SAR, China
| | - Anthony P. Y. Liu
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, Hong Kong SAR, China
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Ţarcă E, Cojocaru E, Trandafir LM, Luca AC, Melinte Popescu AS, Butnariu LI, Melinte Popescu MG, Anton Păduraru DT, Moscalu M, Rusu D, Ţarcă V. Ganglioneuroma of the Bladder in Association with Neurofibromatosis Type 1. Diagnostics (Basel) 2022; 12:diagnostics12123126. [PMID: 36553133 PMCID: PMC9776796 DOI: 10.3390/diagnostics12123126] [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: 10/13/2022] [Revised: 11/26/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is a genetic disease, with autosomal dominant transmission, related to pathogenic variant of the tumor suppressor gene NF1 (17q11.2), predisposing affected subjects to a variety of benign (neurofibromas and plexiform neurofibromas) and malignant tumors. The lack of the NF1-neurofibromin gene product can cause uncontrolled cell proliferation in the central or peripheral nervous system and multisystemic involvement, and so the disease includes a heterogeneous group of clinical manifestations. Ganglioneuromas are benign tumors developing from the neural crest cells of the autonomic nervous system, considered to be part of neuroblastic tumors. Bladder localization is extremely rare in adults, and only three such cases were reported in children so far. The aim of our study, in addition to a brief review of the literature of these pathologies, is to bring to your attention the case of a sixteen year old patient with a very rare association of NF1 and bladder ganglioneuroma, who presented at the hospital with gross hematuria. Since bladder ganglioneuroma is a rare pathological condition, the differential diagnosis is difficult and imaging investigations and pathological investigations are the ones that elucidate this disease. The clinical approach of the medical multidisciplinary team involved should help the patient in managing her medical and surgical situation.
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Affiliation(s)
- Elena Ţarcă
- Department of Surgery II-Pediatric Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Elena Cojocaru
- Department of Morphofunctional Sciences I–Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Laura Mihaela Trandafir
- Department of Mother and Child Medicine–Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
- Correspondence: (L.M.T.); (D.R.)
| | - Alina Costina Luca
- Department of Mother and Child Medicine–Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Alina Sinziana Melinte Popescu
- Department of General Nursing, Faculty of Medicine and Biological Sciences, “Ştefan cel Mare” University of Suceava, 720229 Suceava, Romania
| | - Lăcrămioara Ionela Butnariu
- Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Marian George Melinte Popescu
- Department of General Nursing, Faculty of Medicine and Biological Sciences, “Ştefan cel Mare” University of Suceava, 720229 Suceava, Romania
| | - Dana Teodora Anton Păduraru
- Department of Mother and Child Medicine–Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Mihaela Moscalu
- Department of Preventive Medicine and Interdisciplinarity, ”Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
| | - Daniela Rusu
- Department of Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
- Correspondence: (L.M.T.); (D.R.)
| | - Viorel Ţarcă
- Department of Preventive Medicine and Interdisciplinarity, ”Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, Romania
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Ling K, Xiaoping C, Xiaolu Y. A case of ganglioneuroma of the ureter and review of the literature. J Int Med Res 2022; 50:3000605221123671. [PMID: 36412222 PMCID: PMC9706062 DOI: 10.1177/03000605221123671] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/16/2022] [Indexed: 10/28/2023] Open
Abstract
Ganglioneuroma is a rare tumor originating from neural crest tissue of the sympathetic nervous system. We report on an approximately 55-year-old woman who was admitted to hospital with abdominal pain. Surgery revealed a tumor in her right ureter, which was pathologically confirmed as a ganglioneuroma. The patient underwent transabdominal total hysterectomy, bilateral adnexal resection, release of pelvic and intestinal adhesions, right ureteroscopy, right ureter retrograde intubation, right ureteral lesion excision, and ureteral anastomosis. A literature review indicated that most ganglioneuromas are benign tumors. Clinicians may consider total or subtotal tumor resection, depending on the tumor location and patient's condition. The patient's clinical condition may improve after surgery combined with periodic long-term follow-up.
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Affiliation(s)
- Ke Ling
- Department of Gynecology, Maoming
People’s Hospital, Maoming, China
| | - Chen Xiaoping
- Department of Pathology, Maoming
People’s Hospital, Maoming, China
| | - Yuan Xiaolu
- Department of Pathology, Maoming
People’s Hospital, Maoming, China
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Bladder Ganglioneuroma in a 5-Year-old Girl Presenting With a Urinary Tract Infection and Hematuria: Case Report and Review of the Literature. Urology 2015; 85:467-9. [DOI: 10.1016/j.urology.2014.10.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/16/2014] [Accepted: 10/21/2014] [Indexed: 11/17/2022]
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