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1.
Am J Hum Genet ; 107(4): 636-653, 2020 10 01.
Article in English | MEDLINE | ID: mdl-32946765

ABSTRACT

With mounting interest in translating genome-wide association study (GWAS) hits from large meta-analyses (meta-GWAS) in diverse clinical settings, evaluating their generalizability in target populations is crucial. Here, we consider long-term survivors of childhood cancers from the St. Jude Lifetime Cohort Study, and we show the limited generalizability of 1,376 robust SNP associations reported in the general population across 12 complex anthropometric and cardiometabolic phenotypes (n = 2,231; observed-to-expected replication ratio = 0.70, p = 6.2 × 10-8). An examination of five comparable phenotypes in a second independent cohort of survivors from the Childhood Cancer Survivor Study corroborated the overall limited generalizability of meta-GWAS hits to survivors (n = 4,212; observed-to-expected replication ratio = 0.55, p = 5.6 × 10-15). Finally, in direct comparisons of survivor samples against independent equivalently powered general population samples from the UK Biobank, we consistently observed lower meta-GWAS hit replication rates and poorer polygenic risk score predictive performance in survivor samples for multiple phenotypes. As a possible explanation, we found that meta-GWAS hits were less likely to be replicated in survivors who had been exposed to cancer therapies that are associated with phenotype risk. Examination of complementary DNA methylation data in a subset of survivors revealed that treatment-related methylation patterns at genomic sites linked to meta-GWAS hits may disrupt established genetic signals in survivors.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cancer Survivors , Epigenesis, Genetic , Gene Expression Regulation, Neoplastic , Genes, Neoplasm , Hypothalamic Neoplasms/genetics , Anthropometry/methods , Child , Cohort Studies , DNA Methylation , Female , Genome-Wide Association Study , Genotype , Humans , Hypothalamic Neoplasms/diagnosis , Hypothalamic Neoplasms/pathology , Hypothalamic Neoplasms/therapy , Male , Meta-Analysis as Topic , Metabolome/genetics , Multifactorial Inheritance , Phenotype , Predictive Value of Tests , Risk Assessment
2.
World Neurosurg ; 128: 527-531, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31048046

ABSTRACT

BACKGROUND: Diffuse midline glioma H3 K27M mutant is a new tumor entity described in the revised 2016 World Health Organization classification. It is most frequently observed in children and develops in midline structures, including the brainstem, thalamus, and spine. We describe a rare diffuse midline glioma with an H3 K27M mutation arising in the hypothalamus of an adult. CASE DESCRIPTION: A 27-year-old woman was admitted to our department complaining of amenorrhea, polydipsia, and diuresis for the previous 3 months, and headache and lethargy for approximately 10 days. Computed tomography scan showed an oval isodense solid mass extending from the pituitary toward the suprasellar cistern. A gadolinium-enhanced magnetic resonance imaging (MRI) showed a strongly heterogeneous enhanced solid lesion and nonenhanced cystic lesion. The patient underwent surgery and chemoradiotherapy with temozolomide. Histologic and immunohistochemical analyses revealed H3 K27M-mutant diffuse midline glioma. The patient underwent another resection for a recurrent tumor 5 months after the first surgery. Three months after the second operation, the patient relapsed, with MRI revealing spinal cord and meningeal metastases; she died shortly afterward. CONCLUSIONS: Diffuse midline glioma with an H3 K27M mutation occurring in the hypothalamus of an adult is rare but should be considered in differential diagnoses. Because histone H3 K27M mutations are associated with aggressive clinical behavior and poor prognosis, molecular analyses should be used to determine the clinical and histopathologic features of such tumors. This will contribute to developing targeted drugs and gene therapy going forward.


Subject(s)
Glioma/surgery , Hypothalamic Neoplasms/surgery , Adenoma/diagnosis , Adult , Amenorrhea/etiology , Diagnosis, Differential , Diuresis , Female , Glioma/complications , Glioma/diagnostic imaging , Glioma/genetics , Histones/genetics , Humans , Hypopituitarism/etiology , Hypothalamic Neoplasms/complications , Hypothalamic Neoplasms/diagnostic imaging , Hypothalamic Neoplasms/genetics , Pituitary Neoplasms/diagnosis , Polydipsia/etiology , Sella Turcica/diagnostic imaging
3.
J Child Neurol ; 28(5): 625-32, 2013 May.
Article in English | MEDLINE | ID: mdl-23439714

ABSTRACT

Pilocytic astrocytoma, the most common pediatric brain tumor, is a clinically and molecularly heterogeneous disease that occurs most often in the cerebellum and hypothalamic and chiasmatic regions. Classically, pilocytic astrocytomas are driven by the mitogen-activated protein kinase/extracellular signal-regulated kinase pathway. Recently described genetic aberrations involving this pathway are critical for tumorigenesis. Tandem duplication of 7q34 encodes BRAF and produces several KIAA1549-BRAF novel oncogenic fusions. Activating point mutations of BRAF, such as BRAF (V600E), also lead to pilocytic astrocytoma. Loss of the NF1 gene allows hyperactivation of the oncogene KRAS. In this review, we discuss the current understanding of the novel molecular aberrations described in pilocytic astrocytomas and their clinical relevance for prognosis and treatment. The prognostic indications of these aberrations are discussed with regard to tumor location, tumor pathology, and patient age. A better understanding of the evolving molecular heterogeneity of pilocytic astrocytomas offers hope for developing molecularly targeted therapeutic armamentariums.


Subject(s)
Astrocytoma/genetics , Brain Neoplasms/genetics , Chromosome Aberrations , Genetic Heterogeneity , Astrocytoma/diagnosis , Astrocytoma/therapy , Brain Neoplasms/diagnosis , Brain Neoplasms/therapy , Cell Transformation, Neoplastic/genetics , Cerebellar Neoplasms/diagnosis , Cerebellar Neoplasms/genetics , Cerebellar Neoplasms/therapy , Child , Extracellular Signal-Regulated MAP Kinases/genetics , Genes, Neurofibromatosis 1 , Humans , Hypothalamic Neoplasms/diagnosis , Hypothalamic Neoplasms/genetics , Hypothalamic Neoplasms/therapy , Molecular Targeted Therapy , Optic Chiasm , Optic Nerve Neoplasms/diagnosis , Optic Nerve Neoplasms/genetics , Optic Nerve Neoplasms/therapy , Point Mutation/genetics , Prognosis , Proto-Oncogene Proteins/genetics , Proto-Oncogene Proteins B-raf/genetics , Proto-Oncogene Proteins p21(ras) , Transcriptional Activation/genetics , ras Proteins/genetics
4.
Pediatr Blood Cancer ; 59(5): 930-3, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22213612

ABSTRACT

Hypothalamic obesity syndrome can affect brain tumor patients following surgical intervention and irradiation. This syndrome is rare at diagnosis in childhood cancer, but has been reported with relapse of acute lymphoblastic leukemia. Here we present a case of hypothalamic obesity syndrome as the primary presentation of a toddler found to have CNS+ B-cell lymphoblastic lymphoma. Cytogenetic studies on diagnostic cerebrospinal fluid revealed MLL gene rearrangement (11q23). Hyperphagia and obesity dramatically improved following induction and consolidation chemotherapy. We describe a novel presentation of hypothalamic obesity syndrome in CNS B-cell lymphoblastic lymphoma, responsive to chemotherapy.


Subject(s)
Chromosomes, Human, Pair 11/genetics , Gene Rearrangement , Hypothalamic Neoplasms , Myeloid-Lymphoid Leukemia Protein/genetics , Obesity , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma , Child, Preschool , Histone-Lysine N-Methyltransferase , Humans , Hyperphagia/diagnostic imaging , Hyperphagia/drug therapy , Hyperphagia/genetics , Hypothalamic Neoplasms/diagnostic imaging , Hypothalamic Neoplasms/drug therapy , Hypothalamic Neoplasms/genetics , Male , Obesity/diagnostic imaging , Obesity/drug therapy , Obesity/genetics , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/diagnostic imaging , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/genetics , Radiography
5.
Hum Mutat ; 32(12): 1376-80, 2011 Dec.
Article in English | MEDLINE | ID: mdl-21919124

ABSTRACT

SOX2 is an early developmental transcription factor and marker of stem cells that has recently been implicated in the development of the pituitary gland. Heterozygous SOX2 mutations have been described in patients with hypopituitarism and severe ocular abnormalities. In the majority of published cases, the pituitary gland is either small or normal in size. Here, we report two unrelated patients with SOX2 haploinsufficiency (a heterozygous gene deletion and a novel c.143TC>AA/p.F48X mutation) who developed nonprogressive pituitary tumors of early onset, suggesting a congenital etiology. The truncating mutation resulted in significant loss of function and impaired nuclear localization of the mutant protein, in addition to a failure to repress ß-catenin transcriptional activity in vitro. This is the first indication that SOX2 haploinsufficiency is implicated in the generation of pituitary tumors with distinct clinical characteristics, possibly mediated via its effects on the Wnt signaling pathway.


Subject(s)
Haploinsufficiency/genetics , Heterozygote , Hypothalamic Neoplasms/genetics , SOXB1 Transcription Factors/genetics , Adolescent , Female , Gene Deletion , HEK293 Cells , Humans , Hypopituitarism/congenital , Hypopituitarism/etiology , Hypopituitarism/genetics , Infant , Male , Mutation , Pituitary Gland/pathology , Wnt Signaling Pathway , beta Catenin/genetics , beta Catenin/metabolism
6.
Pediatr Blood Cancer ; 53(7): 1349-51, 2009 Dec 15.
Article in English | MEDLINE | ID: mdl-19653292

ABSTRACT

Frasier syndrome is characterized by a 46 XY disorder of sex development, nephropathy, and increased risk for gonadoblastoma due to Wilms tumor 1(WT1) mutation in the donor splice site of intron-9, resulting in the splice form +KTS. Germ cell tumors and gonadoblastomas have been reported previously in Frasier syndrome. We present the clinical, radiological, and genetic (WT1 mutation analysis) of a 46 XY phenotypic female with Frasier syndrome with bilateral gonadoblastoma with dysgerminoma who developed pilocytic astrocytoma.


Subject(s)
Astrocytoma/genetics , Dysgerminoma/genetics , Frasier Syndrome/genetics , Genes, Wilms Tumor , Gonadoblastoma/genetics , Hypothalamic Neoplasms/genetics , Neoplastic Syndromes, Hereditary/genetics , Point Mutation , RNA Splice Sites/genetics , Astrocytoma/complications , Astrocytoma/pathology , Astrocytoma/surgery , Child , Dysgerminoma/pathology , Dysgerminoma/surgery , Female , Gonadal Dysgenesis, 46,XY/genetics , Gonadoblastoma/pathology , Gonadoblastoma/surgery , Hemianopsia/etiology , Humans , Hypothalamic Neoplasms/complications , Hypothalamic Neoplasms/pathology , Hypothalamic Neoplasms/surgery , Male , Neoplasms, Multiple Primary/genetics , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/surgery , Phenotype , Proteinuria/genetics , Speech Disorders/etiology
8.
Mod Pathol ; 21(11): 1345-56, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18622384

ABSTRACT

Pilomyxoid astrocytoma is a recently identified variant of pilocytic astrocytoma. We studied 11 circumscribed astrocytomas with focal (n=5) or diffuse (n=6) pilomyxoid features and compared them with 17 pilocytic astrocytomas from the hypothalamic/chiasmatic region in children. In one patient, a tumor that recurred after initial surgery had changed from pure-form pilomyxoid astrocytoma to the mixed form. The presence of a pilomyxoid area was associated with shorter survival. Next, we compared the comprehensive genome copy number changes in the pilomyxoid astrocytoma (n=4) with those in pilocytic astrocytoma (n=6) cases by array-based comparative genomic hybridization. The number of lost clones was larger in pilomyxoid astrocytoma than in pilocytic astrocytoma. Clones located in chromosome 8q24.3 were frequently gained in pilocytic astrocytoma (four of six) and in pilomyxoid astrocytoma (one of four). Clones located in 9p24.3 and 15q26.3 were lost in all of the pilomyxoid astrocytomas and in five of the pilocytic astrocytomas. Those in 8p23.3 showed a copy number loss in three of the pilomyxoid astrocytomas and four of the pilocytic astrocytomas. The frequency of copy number changes was significantly different between pilomyxoid astrocytoma and pilocytic astrocytoma in 47 (3.6%) clones, 20 of them having been located in 2p, 10 in 2q, and 11 in 3q. An unsupervised hierarchical clustering analysis classified the cases into three clusters: one pilomyxoid astrocytoma patient into one cluster, two pilomyxoid astrocytoma patients into another cluster, and six pilocytic astrocytoma patients and one pilomyxoid astrocytoma patient into the third cluster. In conclusion, the presence of mixed-form pilomyxoid astrocytoma, the acquisition of pilocytic astrocytoma features in a recurrent tumor in pure-form pilomyxoid astrocytoma, and the above results of the genome-wide gene copy number analysis suggest that pilomyxoid astrocytoma might be a pathologically and genetically related, aggressive variant of pilocytic astrocytoma with partially different genetic alterations.


Subject(s)
Astrocytoma/pathology , Comparative Genomic Hybridization/methods , Gene Dosage , Hypothalamic Neoplasms/pathology , Hypothalamus, Anterior/pathology , Optic Nerve Neoplasms/pathology , Adolescent , Adult , Astrocytoma/genetics , Astrocytoma/mortality , Biomarkers, Tumor/analysis , Brain/pathology , Child , Child, Preschool , Clone Cells , DNA, Neoplasm/genetics , Female , Humans , Hypothalamic Neoplasms/genetics , Hypothalamic Neoplasms/mortality , Hypothalamus, Anterior/surgery , Immunoenzyme Techniques , Infant , Magnetic Resonance Imaging , Male , Neoplasm Recurrence, Local , Optic Nerve Neoplasms/genetics , Optic Nerve Neoplasms/mortality , Survival Rate , Young Adult
9.
J Neuropathol Exp Neurol ; 65(8): 769-75, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16896310

ABSTRACT

Pilocytic astrocytoma (PA) is the most common glioma of childhood. Despite their relatively high incidence, the molecular mechanisms responsible for tumorigenesis and growth of PA are poorly understood. Previous in vitro studies in our laboratory showed that despite the absence of ErbB1, PA was sensitive to ErbB1 tyrosine kinase inhibitor gefitinib. To identify alternative targets of gefitinib in PA, we studied other members of the ErbB receptor tyrosine kinase family that have been identified in brain tumors. Using gene expression microarray and Western blot analyses, we found that ErbB3 is highly overexpressed in PA compared with other pediatric brain tumors (glioblastoma, ependymoma, medulloblastoma, atypical teratoid/rhabdoid tumor, and choroid plexus papilloma). Developmental biology studies have identified Sox10 as a regulator of ErbB3 expression during development of the neural crest. Investigation of Sox10 in PA revealed that it is highly overexpressed relative to other pediatric brain tumors, lending support to the theory that Sox10-regulated overexpression of ErbB3 may be driving growth in PA. Sox10-regulated ErbB3 overexpression is a novel insight into the biology of PA, suggests possible recapitulation of developmental pathways in tumorigenesis, and presents possible targets for therapeutic intervention that might be used for hypothalamic variants not amenable to surgical cure.


Subject(s)
Astrocytoma/genetics , Biomarkers, Tumor/genetics , Brain Neoplasms/genetics , DNA-Binding Proteins/genetics , Gene Expression Regulation, Neoplastic/genetics , High Mobility Group Proteins/genetics , Receptor, ErbB-3/genetics , Transcription Factors/genetics , Adolescent , Astrocytoma/diagnosis , Astrocytoma/metabolism , Blotting, Western , Brain Neoplasms/diagnosis , Brain Neoplasms/metabolism , Cell Transformation, Neoplastic/genetics , Cell Transformation, Neoplastic/metabolism , Child, Preschool , DNA-Binding Proteins/metabolism , Female , Gene Expression Profiling , Genetic Linkage/genetics , Genetic Markers/genetics , Genetic Predisposition to Disease/genetics , High Mobility Group Proteins/metabolism , Humans , Hypothalamic Neoplasms/genetics , Hypothalamic Neoplasms/metabolism , Hypothalamic Neoplasms/physiopathology , Male , Neural Crest/metabolism , Neural Crest/physiopathology , Oligonucleotide Array Sequence Analysis , Receptor, ErbB-3/metabolism , SOXE Transcription Factors , Transcription Factors/metabolism
10.
Neurology ; 63(10): 1944-6, 2004 Nov 23.
Article in English | MEDLINE | ID: mdl-15557519

ABSTRACT

Identification of new optic pathway tumors (OPTs) and progression of pre-existing OPTs in children with neurofibromatosis 1 (NF1) have been reported infrequently after age 6. The authors present eight children with NF1 (mean age 12.2 years) seen in three NF1 centers who had either late-onset (four of eight) or late-progressive (seven of eight) OPT. Continued monitoring of individuals with NF1 into adulthood for the development of OPTs and for progression of known OPTs is warranted.


Subject(s)
Astrocytoma/epidemiology , Neurofibromatosis 1/epidemiology , Optic Nerve Glioma/epidemiology , Optic Nerve Neoplasms/epidemiology , Adolescent , Adult , Age of Onset , Astrocytoma/diagnosis , Astrocytoma/genetics , Astrocytoma/therapy , Case Management , Child , Child, Preschool , Combined Modality Therapy , Disease Progression , Humans , Hypothalamic Neoplasms/epidemiology , Hypothalamic Neoplasms/genetics , Neurofibromatosis 1/diagnosis , Optic Nerve Glioma/diagnosis , Optic Nerve Glioma/genetics , Optic Nerve Glioma/therapy , Optic Nerve Neoplasms/diagnosis , Optic Nerve Neoplasms/genetics , Optic Nerve Neoplasms/therapy , Retrospective Studies
12.
Front Biosci ; 8: a1-9, 2003 Jan 01.
Article in English | MEDLINE | ID: mdl-12456321

ABSTRACT

Deletions of chromosomes 1p and 19q are associated with chemosensitivity and enhanced survival in oligodendrogliomas. Therefore, we have utilized FISH analysis as an ancillary tool for diffuse gliomas with suspected oligodendroglial features. To date, 246 gliomas have been analyzed in 131 male and 93 female patients, including 109 oligodendrogliomas (O), 109 mixed oligoastrocytomas/equivocal gliomas (MOA), and 28 astrocytomas (A). To address specificity, we also analyzed 41 oligodendroglioma mimics, including 12 central and 12 extraventricular neurocytomas (EVN), 12 dysembryoplastic neuroepithelial tumors, and 5 clear cell ependymomas. Aside from 2 EVNs, no mimics demonstrated codeletion. Three patterns were associated with glioma cell type (O vs. MOA/A): -1p/19q, -19q alone, and polysomies. Long-term survivals of >5-years (N=47) and >10-years (N=16) were associated with 1p/19q codeletion in 60% and 75% respectively, whereas solitary 19q deletion accounted for 11% and 6% respectively. Survivals<2-years (N=10) were associated with lack of deletions in 70%. A few older patients with high-grade, "genetically favorable" tumors did poorly, whereas prolonged survival was observed in several low-grade glioma patients despite a lack of the "genetically favorable" pattern. Our data suggests that: 1) FISH-detectable 1p/19q codeletion is relatively specific for oligodendrogliomas with long survival, 2) solitary 19q deletion may also portend a favorable prognosis in a smaller subset, and 3) combined clinicopathologic and genetic assessment likely provides a more accurate means of patient stratification than either one alone.


Subject(s)
Brain Neoplasms/genetics , Chromosomes, Human, Pair 19/genetics , Chromosomes, Human, Pair 1/genetics , Gene Deletion , Glioma/genetics , In Situ Hybridization, Fluorescence/methods , Oligodendroglioma/genetics , Adolescent , Adult , Aged , Brain Neoplasms/diagnosis , Brain Neoplasms/pathology , Child , Child, Preschool , Cohort Studies , Diagnosis, Differential , Disease-Free Survival , Female , Genetic Markers/genetics , Glioma/diagnosis , Glioma/pathology , Humans , Hypothalamic Neoplasms/diagnosis , Hypothalamic Neoplasms/genetics , Hypothalamic Neoplasms/pathology , Male , Middle Aged , Oligodendroglioma/diagnosis , Oligodendroglioma/pathology
14.
Mol Endocrinol ; 9(4): 467-77, 1995 Apr.
Article in English | MEDLINE | ID: mdl-7659090

ABSTRACT

The molecular mechanisms specifying gene expression in individual neurons of the mammalian central nervous system have been difficult to study due to the cellular complexity of the brain and the absence of cultured model systems representing differentiated central nervous system neurons. We have developed clonal, differentiated, neuronal tumor cell lines of the hypothalamic GnRH-producing neurons by targeting tumorigenesis in transgenic mice. These cells (GT1 cells) provide a model system for molecular studies of GnRH gene regulation. Here we present the identification and characterization of a neuron-specific enhancer responsible for directing expression of the rat GnRH gene in GT1 hypothalamic neurons. This approximately 300 base pair (bp) upstream region (-1571 to -1863) confers enhancer activity to a short -173-bp GnRH promoter or to a heterologous promoter only in GT1 cells. The enhancer is bound by multiple GT1 nuclear proteins over its entire length. Deletion of more than 30 bp from either end dramatically reduces activity, and even large internal fragments carrying seven of the eight DNAse I-protected elements show decreased activity. Scanning replacement mutations demonstrate that several of the internal elements are required for activity of the enhancer. Thus, the GnRH gene is targeted to hypothalamic neurons by a complex multicomponent enhancer that relies on the interaction of multiple nuclear-protein binding enhancer elements.


Subject(s)
Enhancer Elements, Genetic , Gene Expression Regulation , Gonadotropin-Releasing Hormone/genetics , Hypothalamus/metabolism , Neurons/metabolism , Animals , Antigens, Polyomavirus Transforming/physiology , Base Sequence , Cell Transformation, Viral , Hypothalamic Neoplasms/genetics , Hypothalamic Neoplasms/pathology , Hypothalamic Neoplasms/virology , Mice , Mice, Transgenic , Molecular Sequence Data , Mutagenesis , Organ Specificity , Promoter Regions, Genetic , Rats , Recombinant Fusion Proteins/biosynthesis , Simian virus 40/genetics , Tumor Cells, Cultured
15.
Clin Dysmorphol ; 3(4): 301-8, 1994 Oct.
Article in English | MEDLINE | ID: mdl-7894735

ABSTRACT

A mother and daughter with Pallister-Hall syndrome are described. This documented parent-to-child transmission supports the hypothesis of autosomal dominant inheritance of this condition. The mother survived childhood and became pregnant without exogenous endocrine supplements, demonstrating that the gene manifests variable expressivity.


Subject(s)
Genes, Dominant , Hamartoma/genetics , Hypopituitarism/genetics , Hypothalamic Diseases/genetics , Hypothalamic Neoplasms/genetics , Polydactyly/genetics , Adult , Female , Humans , Infant, Newborn , Male , Polydactyly/surgery , Pregnancy , Syndactyly/genetics , Syndrome
16.
Am J Med Genet ; 47(3): 321-5, 1993 Sep 01.
Article in English | MEDLINE | ID: mdl-8135274

ABSTRACT

Pallister-Hall syndrome is a usually lethal dysplasia/malformation syndrome characterized by hypothalamic hamartoblastoma, hypopituitarism, postaxial polydactyly, craniofacial malformations, imperforate anus, and other malformations. We report a familial case in a male infant and his female sib fetus, suggesting autosomal recessive inheritance, or germinal mosaicism for an autosomal dominant mutation, or a segregating submicroscopic chromosome abnormality. Detailed endocrine evaluation on the surviving infant revealed documented pituitary function, pituitary deficit, and hypothalamic deficiency. We suggest that hypothalamic dysfunction contributes to the hypopituitarism seen in Pallister-Hall syndrome.


Subject(s)
Abnormalities, Multiple/genetics , Hypopituitarism/genetics , Hypothalamic Hormones/deficiency , Hypothalamic Neoplasms/genetics , Intellectual Disability/genetics , Abnormalities, Multiple/physiopathology , Female , Fetal Diseases/genetics , Hamartoma/genetics , Humans , Hypopituitarism/congenital , Hypothalamic Neoplasms/congenital , Infant, Newborn , Male , Syndrome , Thyroid Hormones/deficiency
17.
Am J Med Genet ; 42(1): 44-50, 1992 Jan 01.
Article in English | MEDLINE | ID: mdl-1308364

ABSTRACT

We report on congenital hypothalamic hamartomas, discovered at autopsy in 3 unrelated fetuses. In the first 2 patients, the tumor was associated with skeletal dysplasia only. In the third patient, it was part of a non-random congenital malformation association, suggestive of Meckel syndrome. In one family, a previous boy died soon after birth with similar craniofacial and skeletal abnormalities. As far as we know, the association between isolated skeletal dysplasia and congenital hypothalamic hamartomas has not yet been documented in the literature. Nevertheless, a spectrum of skeletal abnormalities has been described in association with congenital hypothalamic "hamartoblastoma" and a constellation of variable visceral malformations under the eponym of "Pallister-Hall syndrome" (PHS). A detailed analysis of the PHS reported cases shows that only skeletal dysplasia and oro-facial abnormalities are present constantly. They show similarities with those found in our first 2 cases. These findings prompt us to consider skeletal dysplasia and oro-facial abnormalities as common denominator and minimum criteria required to define a nosologically distinct, possibly familial entity, which we suggest calling "congenital hypothalamic hamartoma syndrome" (CHHS).


Subject(s)
Hamartoma Syndrome, Multiple/genetics , Hypothalamic Neoplasms/genetics , Bone Diseases, Developmental/congenital , Bone Diseases, Developmental/genetics , Female , Fetus/pathology , Hamartoma Syndrome, Multiple/congenital , Hamartoma Syndrome, Multiple/diagnosis , Humans , Hypothalamic Neoplasms/congenital , Hypothalamic Neoplasms/diagnosis , Infant, Newborn , Male
19.
Am J Med Genet ; 7(1): 47-74, 1980.
Article in English | MEDLINE | ID: mdl-7211952

ABSTRACT

We report on six infants with a neonatally lethal malformation syndrome of hypothalamic hamartoblastoma, postaxial polydactyly, and imperforate anus. Some, but not all, patients had laryngeal cleft, abnormal lung lobulation, renal agenesis and/or renal dysplasia, short 4th metacarpals, nail dysplasia, multiple buccal frenula, hypoadrenalism, microphallus, congenital heart defect, and intrauterine growth retardation. The infants also had hypopituitarism and hypoadrenalism. All were sporadic cases, parents were not consanguineous, chromosomes were apparently normal. Family histories were unremarkable. There was insecticide and/or herbicide exposure in several of the cases, but no exposures were common to all 6 mothers. Five of the patients were born within an 8-month period, but all in different geographic locations. It is postulated that this is a previously apparently unreported syndrome of presently unknown cause.


Subject(s)
Anus, Imperforate/genetics , Hamartoma/genetics , Hypopituitarism/genetics , Hypothalamic Neoplasms/genetics , Bone Diseases, Developmental/genetics , Female , Fingers/abnormalities , Genes, Lethal , Humans , Infant, Newborn , Lung/abnormalities , Male , Phenotype , Syndrome , Toes/abnormalities
20.
Am J Med Genet ; 7(1): 75-83, 1980.
Article in English | MEDLINE | ID: mdl-7211954

ABSTRACT

Unusual and virtually identical hypothalamic tumors were recently studied in three unrelated neonates with a similar complex malformation syndrome. Previous reports of either the hypothalamic tumors or the syndrome as a whole have not been found. Each tumor was apparent on the inferior surface of the cerebrum and extended from the optic chiasma to the interpeduncular fossa. The tumor replaced the hypothalamus and other nuclei which originate in the embryonic hypothalamic plate; it was principally composed of cells resembling primitive, undifferentiated germinal cells. The term "hamartoblastoma" is used to designate these tumors in order to emphasize the malformational and neoplastic aspects. In addition, short olfactory tracts suggest a relation to the arrhinencephaly field defect.


Subject(s)
Anus, Imperforate/genetics , Brain/pathology , Hamartoma/pathology , Hypopituitarism/genetics , Hypothalamic Neoplasms/pathology , Female , Hamartoma/genetics , Humans , Hypothalamic Neoplasms/genetics , Infant, Newborn , Male , Syndrome
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