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A Homozygous MSH6 Mutation in a Child with Café-au-Lait Spots, Oligodendroglioma and Rectal Cancer

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Abstract

Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal dominant condition due to heterozygous germline mutations in DNA mismatch repair genes, in particular MLH1, MSH2 and MSH6. Recently, a syndrome was recognized in which children develop haematological malignancies, solid tumours and signs of neurofibromatosis type 1 due to bi-allelic MMR gene mutations in MLH1, MSH2 and PMS2. Here we describe the child of healthy consanguineous parents who had café-au-lait spots, oligodendroglioma, and rectal cancer. The patient was homozygous for the MSH6 mutation c.3386_3388delGTG in exon 5 which has a predicted pathogenic effect. Germline NF1 gene mutation testing was negative. The rectal tumour showed microsatellite instability and absence of MSH6 staining, whereas the brain tumour was MSI stable and showed normal immunohistochemical expression of MSH6. Apparently, not only MLH1, MSH2 and PMS2, but also MSH6 is involved in the syndrome of childhood cancer and signs of neurofibromatosis type 1.

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References

  1. Lynch HT, de la Chapelle A. Genetic susceptibility to non-polyposis colorectal cancer. J Med Genet 1999; 36: 801–18.

    Google Scholar 

  2. Chung DC, Rustgi AK. The hereditary nonpolyposis colorectal cancer syndrome:genetics and clinical implications. Ann Intern Med 2003; 138: 560–70.

    Google Scholar 

  3. Liu T, Yan H, Kuismanen S et al. The role of hPMS2 and hPMS1 in predisposing to colorectal cancer. Cancer Res 2001; 61: 7798–802.

    Google Scholar 

  4. Liu H-X, Zhou X-L, Liu T et al. The role of hMLH3 in familial colorectal cancer. Cancer Res 2003; 63: 1894–9.

    Google Scholar 

  5. Jagmohan-Changur S, Poikonen T, Vilkki S et al. EXO1 variants occur commonly in normal population:evidence against a role in hereditary nonpolyposis colorectal cancer. Cancer Res 2003; 63: 154–8.

    Google Scholar 

  6. Wang Q, Lasset C, Desseigne F et al. Neurofibromatosis and early onset of cancers in MLH1-deficient children. Cancer Res 1999; 59: 294–7.

    Google Scholar 

  7. Ricciardone MD, Özçelik T, Cevher B et al. Human MLH1 deficiency predisposes to hematological malignancy and neurofibromatosis type 1. Cancer Res 1999; 59: 290–3.

    Google Scholar 

  8. De Rosa M, Fasano C, Panariello L et al. Evidence for a recessive inheritance of Turcot 's syndrome caused by compound heterozygous mutations within the PMS2 gene. Oncogene 2000; 19: 1719–23.

    Google Scholar 

  9. Vilkki S, Tsao J-L, Loukola A et al. Extensive somatic microsatellite mutations in normal human tissue. Cancer Res 2001; 61: 4541–4.

    Google Scholar 

  10. Trimbath JD, Petersen GM, Erdman S et al. Café-au-lait spots and early-onset colorectal neoplasia:A variant of HNPCC? Familial Cancer 2001; 1: 101–5.

    Google Scholar 

  11. Whiteside D, McLeod R, Graham G et al. A homozygous germ-line mutation in the human MSH2 gene predisposes to hemato-logical malignancy and multiple café-au-lait spots. Cancer Res 2002; 62: 359–62.

    Google Scholar 

  12. Bougeard G, Charbonnier F, Moerman A et al. Early-onset brain tumor and lymphoma in MSH2-deficient children. Am J Hum Genet 2003; 72: 213–6.

    Google Scholar 

  13. Gallinger S, Aronson M, Shayan K et al. Gastrointestinal cancers and neurofibromatosis type 1 features in children with a germline homozygous MLH1 mutation. Gastroenterology 2004; 126: 576–85.

    Google Scholar 

  14. Friedman JM, Birch PH. Type 1 neurofibromatosis:a descriptive analysis of the disorder in 1,728 patients. Am J Med Genet 1997; 70: 138–43.

    Google Scholar 

  15. Wang Q, Montmain G, Ruano E et al. Neurofibromatosis type 1 gene as a mutational target in a mismatch repair-deficient cell type. Hum Genet 2003; 112: 117–23.

    Google Scholar 

  16. Gutmann DH, Winkeler E, Kabbarah O et al. Mlh1 deficiency accelerates myeloid leukemogenesis in neurofibromatosis 1 (Nf1) heterozygous mice. Oncogene 2003; 22: 4581–5.

    Google Scholar 

  17. Gille JJP, Hogervorst FBL, Pals G et al. Genomic deletions of MSH2 and MLH1 in colorectal cancer families detected by a novel mutation detection approach. Br J Cancer 2002; 87: 892–7.

    Google Scholar 

  18. Wu Y, Berends MJW, Mensink RGJ et al. Association of hereditary nonpolypsosis colorectal cancer-related tumors displaying low microsatellite instability with MSH6 germline mutations. Am J Hum Genet 1999; 65: 1291–8.

    Google Scholar 

  19. Messiaen LM, Callens T, Mortier G et al. Extensive mutation analysis of the NF1 gene allows identification of 95%of mutations and reveals a high frequency of unusual splicing defects. Hum Mutat 2000; 15: 541–55.

    Google Scholar 

  20. Wijnen J, de Leeuw W, Vasen H et al. Familial endometrial cancer in female carriers of MSH6 germline mutations. Nat Genet 1999; 23: 142–4.

    Google Scholar 

  21. Gorlov IP, Gorlova OY, Frazier ML et al. Missense mutations in hMLH1 and hMSH2 are associated with exonic splicing enhancers. Am J Hum Genet 2003; 73: 1157–61.

    Google Scholar 

  22. Hegde MR, Blazo MA, Chin LH et al. A novel homozygous mutation in the MSH6 gene in a Turcot syndrome family characterized by pediatric glioblastoma multiforme,lymphoma, colorectal cancer and neurofibromatosis. Am J Hum Genet 2003; 73(Suppl.5): 391.

    Google Scholar 

  23. De Vos M, Hayward BE, Picton S et al. Novel PMS2 pseudogenes can conceal recessive mutations causing a distinctive childhood cancer syndrome. Am J Hum Genet 2004; 74: 954–64.

    Google Scholar 

  24. Hamilton SR, Liu B, Parsons RE et al.The molecular basis of Turcot 's syndrome. N Engl J Med 1995; 332: 839–47.

    Google Scholar 

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Menko, F.H., Kaspers, G.L., Meijer, G.A. et al. A Homozygous MSH6 Mutation in a Child with Café-au-Lait Spots, Oligodendroglioma and Rectal Cancer. Familial Cancer 3, 123–127 (2004). https://doi.org/10.1023/B:FAME.0000039893.19289.18

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  • DOI: https://doi.org/10.1023/B:FAME.0000039893.19289.18

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