학술논문

Pituitary blastoma: a pathognomonic feature of germ-line DICER1 mutations
Document Type
article
Source
Acta Neuropathologica. 128(1)
Subject
Biomedical and Clinical Sciences
Neurosciences
Genetic Testing
Cancer
Clinical Research
Rare Diseases
Pediatric
Genetics
Human Genome
2.1 Biological and endogenous factors
Aetiology
Child
Preschool
DEAD-box RNA Helicases
DNA Mutational Analysis
Fatal Outcome
Germ-Line Mutation
Humans
Immunohistochemistry
Infant
Magnetic Resonance Imaging
Mutation
Neoplasms
Complex and Mixed
Pedigree
Pituitary Neoplasms
Radiography
Thoracic
Ribonuclease III
Tomography
X-Ray Computed
Treatment Outcome
Clinical Sciences
Neurology & Neurosurgery
Language
Abstract
Individuals harboring germ-line DICER1 mutations are predisposed to a rare cancer syndrome, the DICER1 Syndrome or pleuropulmonary blastoma-familial tumor and dysplasia syndrome [online Mendelian inheritance in man (OMIM) #601200]. In addition, specific somatic mutations in the DICER1 RNase III catalytic domain have been identified in several DICER1-associated tumor types. Pituitary blastoma (PitB) was identified as a distinct entity in 2008, and is a very rare, potentially lethal early childhood tumor of the pituitary gland. Since the discovery by our team of an inherited mutation in DICER1 in a child with PitB in 2011, we have identified 12 additional PitB cases. We aimed to determine the contribution of germ-line and somatic DICER1 mutations to PitB. We hypothesized that PitB is a pathognomonic feature of a germ-line DICER1 mutation and that each PitB will harbor a second somatic mutation in DICER1. Lymphocyte or saliva DNA samples ascertained from ten infants with PitB were screened and nine were found to harbor a heterozygous germ-line DICER1 mutation. We identified additional DICER1 mutations in nine of ten tested PitB tumor samples, eight of which were confirmed to be somatic in origin. Seven of these mutations occurred within the RNase IIIb catalytic domain, a domain essential to the generation of 5p miRNAs from the 5' arm of miRNA-precursors. Germ-line DICER1 mutations are a major contributor to PitB. Second somatic DICER1 "hits" occurring within the RNase IIIb domain also appear to be critical in PitB pathogenesis.