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van der Tuin K, Ruano D, Knijnenburg J, van der Luijt RB, Morreau H, Links TP, Hes FJ. Clinically-relevant Germline Variants in Children with Non-Medullary Thyroid Cancer. J Clin Endocrinol Metab 2024:dgae107. [PMID: 38415346 DOI: 10.1210/clinem/dgae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/13/2024] [Accepted: 02/24/2024] [Indexed: 02/29/2024]
Abstract
CONTEXT The underlying genetic cause of non-medullary thyroid cancer (NMTC) in children is often unknown, hampering both predictive testing of family members and preventive clinical management. OBJECTIVE Our objectives were to investigated the potential heritability in the largest childhood NMTC cohort that has been genotyped to date. DESIGN Nationwide retrospective cohort study. SETTING Tertiary referral centers. PATIENTS In total, 97 patients diagnosed with pediatric NMTC between 1970-2020 were included in this study. INTERVENTION Germline whole genome sequencing (WGS). MAIN OUTCOME The main outcome measures were mutation detection yield in 1) clinically-relevant tumor predisposition genes, and 2) genes previously associated with NMTC. RESULTS In total, 13 of 97 patients (13%) carried a germline (likely) pathogenic (P/LP) variant in a well-known tumor predisposition gene: APC (n=1), BRCA2 (n=2), CHEK2 (n=4), DICER1 (n=4), HOXB13 (n=1), , and MITF (n=1). In addition, one patient was diagnosed with Pendred syndrome (SLC26A4) and nine variants of high interest were found in other NMTC candidate susceptibility genes. CONCLUSION The reported prevalence (13%) of germline variants in well-known tumor predisposing genes and the added value of a revised personal-/family history and histology led us to recommend genetic counseling for all childhood NMTC patients.The detected tumor predisposition syndromes are associated with a risk for second cancers which necessitates additional surveillance of the index patients and pre-symptomatic genetic testing of at risk family members.
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Affiliation(s)
- Karin van der Tuin
- Department of Clinical Genetics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Dina Ruano
- Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Jeroen Knijnenburg
- Department of Clinical Genetics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Rob B van der Luijt
- Department of Clinical Genetics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Hans Morreau
- Department of Pathology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Thera P Links
- Department of Endocrinology, Internal Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Frederik J Hes
- Department of Clinical Genetics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Clinical Sciences, research group Reproduction and Genetics, Centre for Medical Genetics, Laarbeeklaan 101, 1090 Jette Brussels, Belgium
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van der Tuin K, de Vries LS, van den Reek JJCC, Odink RJ. [A monogenetic disorder instead of type 1 diabetes]. Ned Tijdschr Geneeskd 2023; 167. [PMID: 37078572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND Transient Neonatal Diabetes Mellitus (TNDM) is a rare monogenetic disorder characterized by impaired insulin secretion occurring in the first weeks after birth. TNDM goes into remission after a few weeks to months. However, a large number of children develop non-insulin-dependent DM during puberty. CASE DESCRIPTION In this article we describe a woman who had been treated with insulin since early adulthood because of suspected type 1 diabetes (T1D). During the diagnostic process it became clear that she had been diagnosed with TNDM before. Additional genetic testing confirmed the diagnosis of 6q24-related TNDM. She successfully changed from insulin to oral (tolbutamide) treatment. CONCLUSION It is important to pay attention to personal and family history in patients with suspected DM1. Diagnosing monogenic diabetes often has clinical consequences for the index patient as well as family members.
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Affiliation(s)
- Karin van der Tuin
- Leids Universitair Medisch Centrum, afd. Klinische Genetica, Leiden
- Contact: Karin van der Tuin
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Bayley JP, Bausch B, Jansen JC, Hensen EF, van der Tuin K, Corssmit EP, Devilee P, Neumann HP. SDHB variant type impacts phenotype and malignancy in pheochromocytoma-paraganglioma. J Med Genet 2023; 60:25-32. [PMID: 34750193 DOI: 10.1136/jmedgenet-2020-107656] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 10/07/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Traditional genotype-phenotype correlations for the succinate dehydrogenase-complex II (SDH) genes link SDHB variants to thoracic-abdominal pheochromocytoma-paraganglioma (PPGL) and SDHD variants to head and neck paraganglioma (HNPGL). However, in a recent study we found strong and specific genotype-phenotype associations for SDHD variants. In the present study we zoom in on the genotype-phenotype associations of SDHB gene variants, considering the impact of individual gene variants on disease risk and risk of malignancy. METHODS We analysed two large independent data sets, including a total of 448 patients with PPGL and HNPGL, and studied the association of missense or truncating SDHB variants with tumour incidence, age of onset and malignancy risk using binomial testing and Kaplan-Meier analysis. RESULTS Compared with missense variants, truncating SDHB variants were significantly and consistently more common in patients with PPGL, by a 20 percentage point margin. Malignancy was also significantly more common in truncating versus missense variant carriers. No overall differences in age of PPGL onset were noted between carriers of the two variant types, although some individual variants may differ in certain cases. Missense variants were marginally over-represented among patients with HNPGL, but the difference was not statistically significant. CONCLUSION SDHB truncating variants convey an elevated risk for development of both PPGL and malignancy compared with missense variants. These results further support earlier robust associations between truncating variants and PPGL, and also suggest that the two variant types differ in their impact on complex II function, with PPGL/HNPGL tissues displaying differing sensitivities to changes in complex II function.
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Affiliation(s)
- Jean Pierre Bayley
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Birke Bausch
- Department of Medicine II, University of Freiburg Faculty of Medicine, Freiburg, Germany
| | - Jeroen C Jansen
- Department of Otorhinolaryngology, Leids Universitair Medisch Centrum, Leiden, The Netherlands
| | - Erik F Hensen
- Department of Otorhinolaryngology - Head & Neck Surgery, VU Medisch Centrum, Amsterdam, The Netherlands.,Department of Otolaryngology - Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Karin van der Tuin
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Eleonora Pm Corssmit
- Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Devilee
- Departments of Human Genetics and Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hartmut Ph Neumann
- Department of Nephrology, Universitätsklinikum Freiburg, Freiburg, Germany
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4
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Bakhuizen JJ, Hanson H, van der Tuin K, Lalloo F, Tischkowitz M, Wadt K, Jongmans MCJ. Surveillance recommendations for DICER1 pathogenic variant carriers: a report from the SIOPE Host Genome Working Group and CanGene-CanVar Clinical Guideline Working Group. Fam Cancer 2021; 20:337-348. [PMID: 34170462 PMCID: PMC8484187 DOI: 10.1007/s10689-021-00264-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/19/2021] [Indexed: 12/15/2022]
Abstract
DICER1 syndrome is a rare genetic disorder that predisposes to a wide spectrum of tumors. Developing surveillance protocols for this syndrome is challenging because uncertainty exists about the clinical efficacy of surveillance, and appraisal of potential benefits and harms vary. In addition, there is increasing evidence that germline DICER1 pathogenic variants are associated with lower penetrance for cancer than previously assumed. To address these issues and to harmonize DICER1 syndrome surveillance programs within Europe, the Host Genome Working Group of the European branch of the International Society of Pediatric Oncology (SIOPE HGWG) and Clinical Guideline Working Group of the CanGene-CanVar project in the United Kingdom reviewed current surveillance strategies and evaluated additional relevant literature. Consensus was achieved for a new surveillance protocol and information leaflet that informs patients about potential symptoms of DICER1-associated tumors. The surveillance protocol comprises a minimum program and an extended version for consideration. The key recommendations of the minimum program are: annual clinical examination from birth to age 20 years, six-monthly chest X-ray and renal ultrasound from birth to age 6 years, and thyroid ultrasound every 3 years from age 8 to age 40 years. The surveillance program for consideration comprises additional surveillance procedures, and recommendations for DICER1 pathogenic variant carriers outside the ages of the surveillance interval. Patients have to be supported in choosing the surveillance program that best meets their needs. Prospective evaluation of the efficacy and patient perspectives of proposed surveillance recommendations is required to expand the evidence base for DICER1 surveillance protocols.
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Affiliation(s)
- Jette J Bakhuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Genetics, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands
| | - Helen Hanson
- Department of Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Karin van der Tuin
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - Karin Wadt
- Department of Clinical Genetics, Copenhagen University Hospital Righospitalet, Copenhagen, Denmark
| | - Marjolijn C J Jongmans
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. .,Department of Genetics, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
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Thomas LE, Hurley JJ, Sanchez AA, Aznárez MR, Backman AS, Bjork J, Capella G, Clark SK, Colas C, Dekker E, Dolwani S, Ghorbanoghli Z, Gonn M, Gonzalez Romero S, Hes FJ, Jundi H, Kelland S, Latchford AR, Brito HL, Lynch PM, Meuser E, Mork ME, Mort M, Garcia MN, Nielsen M, Parc Y, Ricci MT, Saurin JC, Tuin KVD, Vasen H, Vilar E, Vinet O, Vitellaro M, Walton SJ, West HD, Sampson JR. Duodenal Adenomas and Cancer in MUTYH-associated Polyposis: An International Cohort Study. Gastroenterology 2021; 160:952-954.e4. [PMID: 33130102 DOI: 10.1053/j.gastro.2020.10.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/15/2020] [Accepted: 10/27/2020] [Indexed: 12/30/2022]
Affiliation(s)
| | - Laura E Thomas
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, UK
| | - Joanna J Hurley
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, UK; Department of Gastroenterology, Prince Charles Hospital, Merthyr Tydfil, UK
| | | | | | - Ann-Sofie Backman
- Hereditary Cancer Unit, Cancer Division, Karolinska University Hospital, Stockholm, Sweden; Institution of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Jan Bjork
- Hereditary Cancer Unit, Cancer Division, Karolinska University Hospital, Stockholm, Sweden; Institution of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Gabriel Capella
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Susan K Clark
- The Polyposis Registry, St Marks Hospital, Watford Road, Harrow, UK; Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK
| | | | - Evelien Dekker
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sunil Dolwani
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Zeinab Ghorbanoghli
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mark Gonn
- Hereditary Cancer Unit, Cancer Division, Karolinska University Hospital, Stockholm, Sweden; Institution of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - S Gonzalez Romero
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Frederik J Hes
- Centrum Medische Genetica UZ, Brussels, Belgium; Leiden University Medical Center (LUMC), Department of Clinical Genetics, Leiden, The Netherlands
| | - Hala Jundi
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, UK
| | - Sarah Kelland
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, UK
| | - Andrew R Latchford
- The Polyposis Registry, St Marks Hospital, Watford Road, Harrow, UK; Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK
| | | | - Patrick M Lynch
- Department of Gastroenterolgy, Hepatology and Nutrition, Division of Internal Medicine, UT MD Anderson Cancer Center, Houston, Texas
| | - Elena Meuser
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, UK
| | - Maureen E Mork
- Clinical Cancer Genetics Program, UT MD Anderson Cancer Center, Houston, Texas
| | - Matthew Mort
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, UK
| | - M Navarro Garcia
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Maartje Nielsen
- Leiden University Medical Center (LUMC), Department of Clinical Genetics, Leiden, The Netherlands
| | - Yann Parc
- Department of Digestive Surgery, Hôpital Saint-Antoine AP-HP, Sorbonne Université, Paris, France
| | - Maria T Ricci
- Unit of Hereditary Digestive Tract Tumors, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Karin van der Tuin
- Leiden University Medical Center (LUMC), Department of Clinical Genetics, Leiden, The Netherlands
| | - Hans Vasen
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Eduardo Vilar
- Clinical Cancer Genetics Program, UT MD Anderson Cancer Center, Houston, Texas; Department of Clinical Cancer Prevention, UT MD Anderson Cancer Center, Houston, Texas
| | - Olivier Vinet
- Digestive Department, Edouard Herriot Hospital, Lyon, France
| | - Marco Vitellaro
- Unit of Hereditary Digestive Tract Tumors, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sarah-Jane Walton
- The Polyposis Registry, St Marks Hospital, Watford Road, Harrow, UK; Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK
| | - Hannah D West
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, UK
| | - Julian R Sampson
- Institute of Medical Genetics, Division of Cancer and Genetics, Cardiff University, School of Medicine, Cardiff, UK.
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van der Sluijs PJ, Aten E, Barge-Schaapveld DQ, Bijlsma EK, Bökenkamp-Gramann R, Kaat LD, van Doorn R, van de Putte DF, van Haeringen A, ten Harkel AD, Hilhorst-Hofstee Y, Hoffer MJ, den Hollander NS, van Ierland Y, Koopmans M, Kriek M, Moghadasi S, Nibbeling EA, Peeters-Scholte CM, Potjer TP, van Rij M, Ruivenkamp CA, Rutten JW, Steggerda SJ, Suerink M, Tan RN, van der Tuin K, Visser R, van der Werf –’t Lam AS, Williams M, Witlox R, Santen GW. Correction: Putting genome-wide sequencing in neonates into perspective. Genet Med 2019; 21:2159-2164. [DOI: 10.1038/s41436-018-0363-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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van der Tuin K, de Kock L, Kamping EJ, Hannema SE, Pouwels MJM, Niedziela M, van Wezel T, Hes FJ, Jongmans MC, Foulkes WD, Morreau H. Clinical and Molecular Characteristics May Alter Treatment Strategies of Thyroid Malignancies in DICER1 Syndrome. J Clin Endocrinol Metab 2019; 104:277-284. [PMID: 30260442 DOI: 10.1210/jc.2018-00774] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 09/21/2018] [Indexed: 12/31/2022]
Abstract
CONTEXT DICER1 syndrome is a rare autosomal-dominantly inherited disorder that predisposes to a variety of cancerous and noncancerous tumors of mostly pediatric and adolescent onset, including differentiated thyroid carcinoma (DTC). DTC has been hypothesized to arise secondarily to the increased prevalence of thyroid hyperplastic nodules in syndromic patients. OBJECTIVE To determine somatic alterations in DICER1-associated DTC and to study patient outcomes. DESIGN Retrospective series. SETTING Tertiary referral centers. PATIENTS Ten patients with germline pathogenic DICER1 variants and early-onset DTC. METHODS Somatic DICER1 mutation analysis, extensive somatic DNA variant and gene fusion analyses were performed on all tumors. RESULTS Median age at DTC diagnosis was 13.5 years and there was no recurrent or metastatic disease (median follow-up, 8 years). All thyroid specimens showed diffuse nodular hyperplasia with at least one focus suspicious of DTC but without infiltrative growth, extrathyroidal extension, vascular invasion, or lymph node metastasis. Most of the individual nodules (benign and malignant) sampled from the 10 tumors harbored distinct DICER1 RNase IIIb hotspot mutations, indicating a polyclonal composition of each tumor. Furthermore, nine of 10 DICER1-related DTCs lacked well-known oncogenic driver DNA variants and gene rearrangements. CONCLUSION On the basis of our clinical, histological, and molecular data, we consider that most DICER1-related DTCs form a low-risk subgroup. These tumors may arise within one of multiple benign monoclonal nodules; thus, hemi-thyroidectomy or, more likely, total thyroidectomy may often be required. However, radioiodine treatment may be unnecessary given the patients' ages and the tumors' low propensity for metastases.
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Affiliation(s)
- Karin van der Tuin
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, Netherlands
| | - Leanne de Kock
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Eveline J Kamping
- Department of Clinical Genetics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Sabine E Hannema
- Department of Pediatrics, Leiden University Medical Centre, Leiden, Netherlands
| | - Marie-Jose M Pouwels
- Department of Internal Medicine, Division of Endocrinology, Medical Spectrum Twente, Enschede, Netherlands
| | - Marek Niedziela
- Department of Pediatric Endocrinology and Rheumatology, Karol Jonscher's Clinical Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | - Tom van Wezel
- Department of Pathology, Leiden University Medical Centre, Leiden, Netherlands
| | - Frederik J Hes
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, Netherlands
| | - Marjolijn C Jongmans
- Department of Clinical Genetics, Radboud University Medical Centre, Nijmegen, Netherlands
- Department of Medical Genetics, Utrecht University Medical Center, Utrecht, Netherlands
- Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - William D Foulkes
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Hans Morreau
- Department of Pathology, Leiden University Medical Centre, Leiden, Netherlands
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8
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van der Tuin K, Mensenkamp AR, Tops CMJ, Corssmit EPM, Dinjens WN, van de Horst-Schrivers ANA, Jansen JC, de Jong MM, Kunst HPM, Kusters B, Leter EM, Morreau H, van Nesselrooij BMP, Oldenburg RA, Spruijt L, Hes FJ, Timmers HJLM. Clinical Aspects of SDHA-Related Pheochromocytoma and Paraganglioma: A Nationwide Study. J Clin Endocrinol Metab 2018; 103:438-445. [PMID: 29177515 DOI: 10.1210/jc.2017-01762] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/16/2017] [Indexed: 02/02/2023]
Abstract
CONTEXT Paraganglioma (PGL) has the highest degree of heritability among human neoplasms. Current clinical understanding of germline SDHA mutation carriers is limited. OBJECTIVE To estimate the contribution of SDHA mutations in PGL and to assess clinical manifestations and age-related penetrance. DESIGN Nationwide retrospective cohort study. SETTING Tertiary referral centers in the Netherlands (multicenter). PATIENTS Germline SDHA analysis was performed in 393 patients with genetically unexplained PGL. Subsequently, 30 index SDHA mutation carriers and 56 nonindex carriers were studied. MAIN OUTCOME MEASURES SDHA mutation detection yield, clinical manifestations, and SDHA-related disease penetrance. RESULTS Pathogenic germline SDHA variants were identified in 30 of the 393 referred patients with PGL (7.6%), who had head and neck PGL (21 of 174 [12%]), pheochromocytoma (4 of 191 [2%]), or sympathetic PGL (5 of 28 [18%]). The median age at diagnosis was 43 years (range, 17 to 81 years) in index SDHA mutation carriers compared with 52 years (range, 7 to 90 years) in nonmutation carriers (P = 0.002). The estimated penetrance of any SDHA-related manifestation was 10% at age 70 years (95% confidence interval, 0% to 21%) in nonindex mutation carriers. CONCLUSION Germline SDHA mutations are relatively common (7.6%) in patients with genetically unexplained PGL. Most index patients presented with apparently sporadic PGL. In this SDHA series, the largest assembled so far, we found the lowest penetrance of all major PGL predisposition genes. This suggests that recommendations for genetic counseling of at-risk relatives and stringency of surveillance for SDHA mutation carriers might need to be reassessed.
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Affiliation(s)
- Karin van der Tuin
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Arjen R Mensenkamp
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Carli M J Tops
- Department of Clinical Genetics, Laboratory for Diagnostic Genetic Analysis, Leiden University Medical Center, Leiden, the Netherlands
| | - Eleonora P M Corssmit
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
| | - Winand N Dinjens
- Department of Pathology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Jeroen C Jansen
- Department of Otorhinolaryngology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mirjam M de Jong
- Department of Clinical Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Henricus P M Kunst
- Department Otorhinolaryngology, Head and Neck Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Benno Kusters
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Edward M Leter
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Hans Morreau
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Rogier A Oldenburg
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Liesbeth Spruijt
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Frederik J Hes
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Henri J L M Timmers
- Department of Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, the Netherlands
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9
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van der Tuin K, Tops CMJ, Adank MA, Cobben JM, Hamdy NAT, Jongmans MC, Menko FH, van Nesselrooij BPM, Netea-Maier RT, Oosterwijk JC, Valk GD, Wolffenbuttel BHR, Hes FJ, Morreau H. CDC73-Related Disorders: Clinical Manifestations and Case Detection in Primary Hyperparathyroidism. J Clin Endocrinol Metab 2017; 102:4534-4540. [PMID: 29040582 DOI: 10.1210/jc.2017-01249] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/09/2017] [Indexed: 11/19/2022]
Abstract
CONTEXT Heterozygous pathogenic germline variants in CDC73 predispose to the development of primary hyperparathyroidism (pHPT) and, less frequently, ossifying fibroma of the jaw and renal and uterine tumors. Clinical information on CDC73-related disorders has so far been limited to small case series. OBJECTIVE To assess the clinical manifestations and penetrance in CDC73-related disorders and to improve case detection in pHPT. DESIGN Nationwide retrospective Dutch cohort study. SETTING Tertiary referral center. PATIENTS We studied 89 patients with pHPT referred for germline CDC73 analysis and 43 subsequently tested relatives who proved to be mutation carriers. INVESTIGATION Germline CDC73 mutation analysis. MEAN OUTCOME CDC73 mutation detection yield, referral rate, and CDC73-related disease penetrance. RESULTS Pathogenic germline CDC73 variants were identified in 11 of the 89 referred pHPT patients (12.4%), with (suspected) hyperparathyroidism-jaw tumor (HPT-JT) syndrome (n = 3), familial isolated pHPT (n = 5), apparently sporadic parathyroid carcinoma (n = 2), and apparently sporadic parathyroid adenoma (n = 1). The estimated penetrance of CDC73-related disorders was 65% at age 50 years (95% confidence interval, 48% to 82%) in 43 nonindex mutation carriers. CONCLUSIONS Germline CDC73 analysis is recommended in individuals with (suspected) HPT-JT syndrome, familial isolated pHPT, atypical or malignant parathyroid histology, and young individuals with pHPT. These criteria would increase germline CDC73 mutation detection, enabling optimal clinical management of pHPT as well as genetic counseling and surveillance for family members at risk for developing CDC73-related disorders.
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Affiliation(s)
- Karin van der Tuin
- Department of Clinical Genetics, Leiden University Medical Center, the Netherlands
| | - Carli M J Tops
- Department of Clinical Genetics, Laboratory for Diagnostic Genetic Analysis, Leiden University Medical Center, the Netherlands
| | - Muriel A Adank
- Department of Clinical Genetics, VU Medical Center, the Netherlands
| | | | - Neveen A T Hamdy
- Center for Endocrine Tumors Leiden, Division of Endocrinology, Department of Medicine, Leiden University Medical Center, the Netherlands
| | - Marjolijn C Jongmans
- Department of Clinical Genetics, Radboud University Medical Center, the Netherlands
- Department of Medical Genetics, Utrecht University Medical Center, the Netherlands
- Princess Maxima Center for Pediatric Oncology, the Netherlands
| | - Fred H Menko
- Family Cancer Clinic, Netherlands Cancer Institute, the Netherlands
| | | | - Romana T Netea-Maier
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, the Netherlands
| | - Jan C Oosterwijk
- Department of Genetics, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Gerlof D Valk
- Department of Endocrine Oncology, University Medical Center Utrecht, the Netherlands
| | | | - Frederik J Hes
- Department of Clinical Genetics, Leiden University Medical Center, the Netherlands
| | - Hans Morreau
- Department of Pathology, Leiden University Medical Center, the Netherlands
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van der Tuin K, Hannema SE, Houdijk ECAMM, Losekoot M, de Koning EJP, Breuning MH. [Maturity-onset diabetes of the young]. Ned Tijdschr Geneeskd 2015; 159:A9247. [PMID: 26374728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Maturity-onset diabetes of the young (MODY) is the most common type of monogenic diabetes mellitus, estimated to account for approximately 1-4% of patients with diabetes. The predicted prevalence is, therefore, 20,000 patients in The Netherlands. Unfortunately less than 5% of these patients are confirmed by molecular genetic analysis. MODY is a clinically heterogeneous group of disorders caused by β-cell dysfunction, which is caused by mutations in multiple genes. MODY is characterized by an early onset of diabetes (often before the age of 30 years) and autosomal dominant inheritance. Patients do not usually require insulin at diagnosis. To emphasize the importance of genetic analysis we describe a 7-year-old boy and his siblings with MODY type 2. Molecular genetic testing is essential for individual patient care, as treatment options differ between the various forms of MODY; it also provides an opportunity to screen relatives.
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