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American Journal of Medical Genetics.... Apr 2013We report on a pedigree with a pair of brothers each with minor anomalies, developmental delay, and autistic-symptoms who share an unbalanced translocation (not...
We report on a pedigree with a pair of brothers each with minor anomalies, developmental delay, and autistic-symptoms who share an unbalanced translocation (not detectable by karyotype). The unbalanced translocation involves a 7.1 Mb loss of the terminal portion of 10q, and a 4.2 Mb gain of 11q. One of the brothers also developed a cerebellar juvenile pilocytic astrocytoma. The father was found to be a balanced carrier and the couple had a previous miscarriage. We demonstrate that the breakpoint for the triplicated region from chromosome 11 is adjacent to two IgLON genes, namely Neurotrimin (NTM) and Opioid Binding Protein/Cell Adhesion Molecule-like (OPCML). These genes are highly similar neural cell adhesion molecules that have been implicated in synaptogenesis and oncogenesis, respectively. The children also have a 10q deletion and are compared to other children with the 10q deletion syndrome which generally does not involve autism spectrum disorders (ASDs) or cancer. Together these data support a role for NTM and OPCML in developmental delay and potentially in cancer susceptibility.
Topics: Astrocytoma; Cerebellar Neoplasms; Child; Child Development Disorders, Pervasive; Child, Preschool; Chromosome Deletion; Chromosomes, Human, Pair 10; Chromosomes, Human, Pair 11; Comparative Genomic Hybridization; Cytoskeletal Proteins; Humans; In Situ Hybridization, Fluorescence; Karyotype; Male; Pedigree; Proteins; Translocation, Genetic; Trisomy
PubMed: 23495067
DOI: 10.1002/ajmg.a.35841 -
Hong Kong Medical Journal = Xianggang... Feb 2013To investigate the pattern of malignancies in Chinese patients with neurofibromatosis type 1.
OBJECTIVE
To investigate the pattern of malignancies in Chinese patients with neurofibromatosis type 1.
DESIGN
Historical cohort study.
SETTING
Queen Mary Hospital and Duchess of Kent Children's Hospital in Hong Kong.
PATIENTS
Patients with neurofibromatosis type 1 seen between January 1995 and August 2011.
RESULTS
We identified 123 Chinese patients with neurofibromatosis type 1, diagnosed at a median age of 4.9 years (range, 0.1-16.1 years); 75 (61%) were males. They were followed up for a median of 9.7 years (range, 0.2-27.6 years). Most (80%) of the patients participated in our surveillance programme. Twelve patients developed malignancies at the ages of 0.8 to 41.6 years. These malignancies included: peripheral nerve sheath tumours (n=3), juvenile myelomonocytic leukaemia (n=2), optic nerve glioma (n=1), thalamic pilocytic astrocytoma (n=1), rhabdomyosarcoma (n=1), osteosarcoma (n=1), neuroblastoma (n=1), anaplastic large cell lymphoma (n=1), and breast carcinoma and subsequently carcinoma of the ampulla of Vater (n=1). Among them, three had their tumours (optic glioma, thalamic astrocytoma, sacral malignant peripheral nerve sheath tumour) initially detected by surveillance imaging. Four patients survived without disease progression, three are alive with active disease, the remaining five died (when aged 3 to 56 years) with progressive or relapsed malignancies. The latter patients died from a neuroblastoma, a juvenile myelomonocytic leukaemia, a malignant peripheral nerve sheath tumour, a lymphoma, and a second primary tumour (carcinoma of ampulla of Vater, at the age of 56 years). In neurofibromatosis type 1 patients with malignancy, overall 30-year survival was significantly shorter than in those without malignancy (35% vs 93%, P<0.001).
CONCLUSION
Chinese patients with neurofibromatosis type 1 are susceptible to different malignancies which contribute to mortality. These findings are similar to reports from overseas. Outcomes were unfavourable, except in patients having low-grade gliomas. Surveillance imaging may help early detection of deep-seated malignancies but the benefits accruing from such monitoring warrants prospective evaluation.
Topics: Adolescent; Child; Child, Preschool; China; Cohort Studies; Female; Follow-Up Studies; Hong Kong; Humans; Infant; Male; Neoplasms; Neurofibromatosis 1; Retrospective Studies; Survival Rate
PubMed: 23378354
DOI: No ID Found -
Journal of Neuro-oncology Feb 2013Diffuse intrinsic pontine glioma (DIPG) is a brain cancer with a median survival of only 1 year. Lack of molecular characterization of this tumor impedes the development...
Diffuse intrinsic pontine glioma (DIPG) is a brain cancer with a median survival of only 1 year. Lack of molecular characterization of this tumor impedes the development of novel therapies. Membrane protein B7-H3, aka CD276, involved in interactions with host defenses in certain cancers, has been shown to be over-expressed in the majority of malignant neuroectodermal tumors including adult high-grade glioma. Targeting B7-H3 with a monoclonal antibody has demonstrated safety and efficacy in the salvage treatment of stage IV childhood neuroblastoma, another neuroectodermal tumor. It thus stands to reason that B7-H3 might serve as a therapeutic target in DIPG. B7-H3 immunoreactivity was determined in DIPG and non-diffuse brainstem glioma specimens with immunohistochemistry. In addition, B7-H3 mRNA expression was evaluated with microarrays in another set of specimens. All of the nine (100 %) DIPG specimens were shown to be B7-H3 immunoreactive. In the non-diffuse brainstem glioma group, none of the eight WHO grade I specimens showed B7-H3 immunoreactivity and nine of the 24 WHO grade II specimens (37.5 %) showed B7-H3 immunoreactivity. The association between histological grade and B7-H3 immunoreactivity was statistically highly significant. B7-H3 mRNA expression was also significantly higher in DIPG samples than in normal brain and juvenile pilocytic astrocytoma (WHO grade I) specimens. In summary, B7-H3 is over-expressed in DIPG. Given the need for novel treatment in this disease, antibody-based immunotherapy against B7-H3 in DIPG warrants further investigation.
Topics: B7 Antigens; Brain Stem Neoplasms; Child; Child, Preschool; Female; Gene Expression Profiling; Glioma; Humans; Infant; Magnetic Resonance Imaging; Male; Oligonucleotide Array Sequence Analysis; RNA, Messenger; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 23232807
DOI: 10.1007/s11060-012-1021-2 -
Case Reports in Oncological Medicine 2012Secondary glioblastoma multiforme (sGBM) can occur after a long latency period following radiation treatment of various diseases including brain tumors, leukemia, and...
Secondary glioblastoma multiforme (sGBM) can occur after a long latency period following radiation treatment of various diseases including brain tumors, leukemia, and more benign disorders like tinea capitis. Outcomes of radiation-induced sGBM remain poor in both children and adults. We report a case of a 16-year-old girl with a history of disseminated juvenile pilocytic astrocytoma treated with chemotherapy and craniospinal radiation 9 years prior who developed sGBM in the absence of a tumor predisposition syndrome. She presented with a several-week history of headaches and no acute findings on computed tomography compared to baseline neuroimaging 3 months prior. Repeat computed tomography performed just 3 weeks later for worsening headaches revealed a new large posterior fossa tumor where pathology confirmed the diagnosis of sGBM. In spite of maximal surgical resection, reirradiation, and adjuvant chemotherapy, she died 1 year postdiagnosis. Our case highlights the potential late effects of high-dose cranial radiation, how symptomatology may precede neuroimaging findings, and the rapid formation of sGBM that mirrors that of de novo Glioblastoma Multiforme.
PubMed: 23227384
DOI: 10.1155/2012/290905 -
National Toxicology Program Technical... Jul 2012Styrene-acrylonitrile trimer (SAN Trimer) is a mixture of isomers formed by the condensation of two moles of acrylonitrile and one mole of styrene and has a molecular...
UNLABELLED
Styrene-acrylonitrile trimer (SAN Trimer) is a mixture of isomers formed by the condensation of two moles of acrylonitrile and one mole of styrene and has a molecular weight of 210. The mixture is composed of two structural forms: 4-cyano-1,2,3,4-tetrahydro-a-methyl-1-naphthaleneacetonitrile (THNA, CAS No. 57964-39-3) and 4-cyano-1,2,3,4-tetrahydro-1-naphthalenepropionitrile (THNP, CAS No. 57964-40-6). The THNA form consists of four stereoisomers. [Structure:see text]. The THNP form consists of two stereoisomers. [Structure:see text]. SAN Trimer is a by-product of the production of acrylonitrile styrene plastics and is created in specific manufacturing processes for polymers of acrylonitrile and styrene. In June 1998, due to community concerns about the toxicity of SAN Trimer, it was nominated to the NTP for carcinogenicity testing by a member of Congress. Male and female F344/N rats were exposed to SAN Trimer in feed in perinatal and postnatal studies for 7 weeks, 18 weeks, or 2 years. Genetic toxicology studies were conducted in Salmonella typhimurium and Escherichia coli, and in rat reticulocytes, leukocytes, liver cells, and brain cells. In vivo comet and micronucleus assays were performed in the juvenile rats. 7-WEEK STUDY IN RATS: Groups of 10 male and 10 female rats were fed diets containing 0, 250, 500, 1,000, 2,000, or 4,000 ppm SAN Trimer (equivalent to average daily doses of approximately 50, 90, 175, 270, or 410 mg SAN Trimer/kg body weight to males and 45, 90, 185, 295, or 430 mg/kg to females) for 2 weeks postweaning; the dams of these rats were fed the same concentrations of SAN Trimer from gestation day 7 until the pups were weaned. One 4,000 ppm male rat died 3 days after weaning; all other rats that started the postweaning phase survived to the end of the study. Mean body weights of 1,000, 2,000, and 4,000 ppm males and 2,000 and 4,000 ppm females were significantly less than those of the controls; weaning mean body weights were reduced in 4,000 ppm males and females and in 2,000 ppm females. Feed consumption by 2,000 and 4,000 ppm males and females was less than that by the control groups. Thinness in 4,000 ppm male rats was the only clinical finding related to SAN Trimer exposure. Nonneoplastic lesions were observed in the brain, thymus, spleen, liver, kidney, and reproductive organs of males and females and were considered due to overt toxicity. 18-WEEK STUDY IN RATS: Groups of 10 male and 10 female rats were fed diets of 0, 100, 200, 400, 800, or 1,600 ppm SAN Trimer (equivalent to average daily doses of 10, 20, 40, 80, or 150 mg/kg to males and females) for 3 months postweaning; the dams of these rats were fed the same concentrations from gestation day 7 until the pups were weaned. All rats survived to the end of the study. Mean body weights of 1,600 ppm males and females exposed to 200 ppm or greater were significantly less than those of the controls. At termination, brown staining of the urogenital fur was observed in females exposed to 200 ppm or greater. The liver weights of all exposed groups of males and the spleen weights of 800 and 1,600 ppm males and 1,600 ppm females were significantly greater than those of the controls. There were no significant differences in sperm parameters of male rats or the estrous cyclicity of female rats administered 400, 800, or 1,600 ppm in the diet when compared to the control groups. No exposure-related histopathologic lesions were observed. 2-YEAR STUDY IN RATS: Groups of 50 male and 50 female core study rats were fed diets of 0, 400, 800, or 1,600 ppm SAN Trimer (equivalent to average daily doses of approximately 20, 40, or 75 mg/kg to males and 20, 40, or 85 mg/kg to females) for 2 years. Special study groups of 20 males and 20 females were fed the same exposure concentrations and were evaluated at 27, 52, and 78 weeks for hematology and clinical chemistry or at 26, 51, and 77 weeks for urinalysis. The dams of core and special study rats were fed the same concentrations from gestation day 7 until the pups were weaned. Mean body weights of 1,600 ppm males were less than 90% of the controls after week 1; mean body weights of 800 and 1,600 ppm females were less than 90% of the controls after weeks 41 and 13, respectively. Feed consumption by exposed groups of males and females was generally similar to that by the control groups. Brown staining of the urogenital fur was observed in all exposed groups, and the number of animals affected increased with increasing exposure concentration. Rare neoplasms were present in the central nervous system of male and female rats. In the original evaluation, the 800 and 1,600 ppm groups of male rats each had one astrocytoma and one granular cell tumor in the brain. Also in the brain, one 400 ppm female had a granular cell tumor and one control, one 400 ppm, and one 800 ppm female had a mixed cell glioma. In the spinal cord, one astrocytoma was noted in a 1,600 ppm male in the original evaluation. In the expanded review of the spinal cord, one granular cell tumor was found in a 400 ppm male and one meningioma was found in an 800 ppm female. There were statistically significant increases in the incidence of spinal nerve root degeneration in 1,600 ppm males and the incidences of sciatic nerve degeneration in 800 and 1,600 ppm females. More importantly, there were increases in the severities of both nerve lesions in males and in the severity of spinal nerve root degeneration in females. The incidences of bone marrow hyperplasia were significantly increased in 1,600 ppm males and females and 800 ppm females. Incidences of bone marrow granulomatous inflammation were increased in 1,600 ppm males and 800 and 1,600 ppm females, and the increase in the 800 ppm females was significant. Because this lesion is very rare and did not occur in control animals, it should be considered biologically significant. In the liver, the incidence of eosinophilic focus was significantly increased in 1,600 ppm males and the incidences of mixed cell focus were significantly increased in 400 and 1,600 ppm males. Incidences of mixed cell focus were increased in the liver of all exposed groups of females, and the increase was significant in the 1,600 ppm group. The incidence of transitional epithelial hyperplasia of the urinary bladder in 1,600 ppm females was significantly greater than that in the controls. There were significant decreases in the incidences of pituitary gland pars distalis adenoma in 1,600 ppm males and females, and the incidences in both sexes occurred with negative trends. The incidences of mammary gland fibroadenoma occurred in females with a negative trend, and the incidences in 800 and 1,600 ppm females were significantly less than that in the control group. The incidences of mononuclear cell leukemia in all exposed groups of males and females were significantly less than those in the controls.
GENETIC TOXICOLOGY
SAN Trimer (Batch 3) was not mutagenic in Salmonella typhimurium strains TA98 or TA100 or in Escherichia coli strain WP2 uvrA/pKM101 in tests conducted with and without exogenous metabolic activation. In vivo, however, results of a comet assay indicated significantly increased levels of DNA damage in brain cells of male and female juvenile rats following administration of SAN Trimer (Batch 3) by oral gavage. Dose-related increases in DNA damage in liver cells of these rats were also observed, but the increases were smaller than those observed in brain cells and were judged to be equivocal in both males and females. Indications of DNA damage following exposure to SAN Trimer were also seen in leukocytes of male and female rats. Increases in male rats were significant, but in females, observed levels of DNA damage did not correlate with dose. Therefore, the results were judged to be positive in males and equivocal in females. In addition to the positive comet assay results, significant increases in the frequencies of micronucleated reticulocytes were observed in peripheral blood of male and female juvenile rats dosed with SAN Trimer.
CONCLUSIONS
Under the conditions of this 2-year feed study preceded by perinatal exposure, there was no evidence of carcinogenic activity of SAN Trimer in male and female F344/N rats given feed containing 400, 800, or 1,600 ppm SAN Trimer. Exposure to SAN Trimer resulted in increased incidences and/or severities of peripheral nerve degeneration in male and female F344/N rats, increased incidences of nonneoplastic lesions of the bone marrow and liver in male and female F344/N rats, and of nonneoplastic urinary bladder lesions in female F344/N rats. The incidences of pituitary gland adenoma and mononuclear cell leukemia in male and female F344/N rats and mammary gland fibroadenoma in female F344/N rats were decreased.
Topics: Acrylonitrile; Administration, Oral; Animals; Animals, Newborn; Body Weight; Bone Marrow; Carcinogenicity Tests; Escherichia coli; Female; Liver; Male; Neoplasms; Pregnancy; Rats; Rats, Inbred F344; Salmonella typhimurium; Styrene
PubMed: 22837102
DOI: No ID Found -
Nature Medicine Aug 2012Primary astrocytomas of grade 3 or 4 according to the classification system of the World Health Organization (high-grade astrocytomas or HGAs) are preponderant among...
Primary astrocytomas of grade 3 or 4 according to the classification system of the World Health Organization (high-grade astrocytomas or HGAs) are preponderant among adults and are almost invariably fatal despite the use of multimodal therapy. Here we show that the juvenile brain has an endogenous defense mechanism against HGAs. Neural precursor cells (NPCs) migrate to HGAs, reduce glioma expansion and prolong survival time by releasing endovanilloids that activate the vanilloid receptor (transient receptor potential vanilloid subfamily member-1 or TRPV1) on HGA cells. TRPV1 is highly expressed in tumor and weakly expressed in tumor-free brain. TRPV1 stimulation triggers tumor cell death through the branch of the endoplasmic reticulum stress pathway that is controlled by activating transcription factor-3 (ATF3). The antitumorigenic response of NPCs is lost with aging. NPC-mediated tumor suppression can be mimicked in the adult brain by systemic administration of the synthetic vanilloid arvanil, suggesting that TRPV1 agonists have potential as new HGA therapeutics.
Topics: Aging; Amides; Amidohydrolases; Animals; Antineoplastic Agents; Apoptosis; Arachidonic Acids; Brain; Brain Neoplasms; Capsaicin; Cell Movement; Culture Media, Conditioned; Dopamine; Endocannabinoids; Ethanolamines; Female; Gene Expression Regulation, Neoplastic; Glioblastoma; Humans; Male; Mice; Mice, Inbred C57BL; Mice, Knockout; Mice, SCID; Neoplasm Proteins; Neural Stem Cells; Oleic Acids; Palmitic Acids; Polyunsaturated Alkamides; RNA, Small Interfering; Real-Time Polymerase Chain Reaction; TRPV Cation Channels; Tumor Cells, Cultured
PubMed: 22820645
DOI: 10.1038/nm.2827 -
Interventional Neuroradiology : Journal... Jun 2012Pilocytic astrocytomas are highly vascular, relatively common primary brain tumors in the pediatric population, but their association with a true arteriovenous...
Pilocytic astrocytomas are highly vascular, relatively common primary brain tumors in the pediatric population, but their association with a true arteriovenous malformation (AVM) is extremely rare. We describe an eight-year-old girl with a right supratentorial juvenile pilocytic astrocytoma (WHO grade I) with an angiographically documented AVM entangled in the tumor mass who presented with intracranial hemorrhage due to a ruptured anterior choroidal artery pseudoaneurysm encased in the lesion. The AVM nidus as well as the hemorrhage site was embolized with Onyx. A literature review revealed only one previous report of a true intermixture of these two lesions. We hypothesize whether the association of vascular malformations and primary brain tumors are merely coincidental or if they point to the existence of a distinct entity and/or a common etiologic factor.
Topics: Astrocytoma; Cerebral Angiography; Child; Contrast Media; Diagnosis, Differential; Female; Humans; Intracranial Arteriovenous Malformations; Magnetic Resonance Angiography; Neurologic Examination; Tomography, X-Ray Computed
PubMed: 22681727
DOI: 10.1177/159101991201800203 -
Case Reports in Neurology Jan 2012A 13-year-old girl with a remote history of juvenile pilocytic astrocytoma developed acute onset flushing, tachycardia and shortness of breath immediately following...
A 13-year-old girl with a remote history of juvenile pilocytic astrocytoma developed acute onset flushing, tachycardia and shortness of breath immediately following administration of gadopentetate dimeglumine during routine brain MRI that subsided following intravenous diphenhydramine. A retrospective review of the MRI results revealed multiple areas of contrast enhancement of the face, consistent with observed urticaria. The patient received pretreatment medications prior to subsequent gadolinium injections without incident. Gadolinium allergy is extremely rare and has been reported in less than 0.1% of injections. However, in patients who undergo anesthesia for MRI studies, similar subtle extracranial MRI findings should alert the neuroradiologist to possible gadolinium allergy that may warrant premedication prior to future injections.
PubMed: 22649344
DOI: 10.1159/000338631 -
Human Genomics Oct 2011Somatic gene mutations constitute key events in the malignant transformation of human cells. Somatic mutation can either actively speed up the growth of tumour cells or... (Review)
Review
Somatic gene mutations constitute key events in the malignant transformation of human cells. Somatic mutation can either actively speed up the growth of tumour cells or relax the growth constraints normally imposed upon them, thereby conferring a selective (proliferative) advantage at the cellular level. Neurofibromatosis type-1 (NF1) affects 1/3,000-4,000 individuals worldwide and is caused by the inactivation of the NF1 tumour suppressor gene, which encodes the protein neurofibromin. Consistent with Knudson's two-hit hypothesis, NF1 patients harbouring a heterozygous germline NF1 mutation develop neurofibromas upon somatic mutation of the second, wild-type, NF1 allele. While the identification of somatic mutations in NF1 patients has always been problematic on account of the extensive cellular heterogeneity manifested by neurofibromas, the classification of NF1 somatic mutations is a prerequisite for understanding the complex molecular mechanisms underlying NF1 tumorigenesis. Here, the known somatic mutational spectrum for the NF1 gene in a range of NF1-associated neoplasms - including peripheral nerve sheath tumours (neurofibromas), malignant peripheral nerve sheath tumours, gastrointestinal stromal tumours, gastric carcinoid, juvenile myelomonocytic leukaemia, glomus tumours, astrocytomas and phaeochromocytomas - have been collated and analysed.
Topics: Genes, Neurofibromatosis 1; Humans; Mutation; Neurofibromatosis 1
PubMed: 22155606
DOI: 10.1186/1479-7364-5-6-623