An Asymptomatic, Ectopic Mass as a Presentation of Adrenocortical Carcinoma Due to a Novel Germline TP53 p.Phe338Leu Tetramerisation Domain Variant

Adrenocortical carcinoma (ACC) is a rare cancer in childhood. ACC is frequently associated with germline TP53 variants, with founder effects especially due to the p.Arg337His mutation. ACC leads to the secretion of adrenocortical hormones, resulting in endocrine syndromes, which is the usual trigger...

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Bibliographic Details
Published in:Children (Basel) 2023-11, Vol.10 (11), p.1793
Main Authors: Walenciak, Justyna, Urbanska, Zuzanna, Pastorczak, Agata, Babol-Pokora, Katarzyna, Wypyszczak, Kamila, Bien, Ewa, Gawlowska-Marciniak, Aleksandra, Kobos, Jozef, Grajkowska, Wieslawa, Smyczynska, Joanna, Mlynarski, Wojciech, Janczar, Szymon
Format: Article
Language:English
Subjects:
adrenocortical carcinoma
Asymptomatic
Cancer
cancer predisposition
Chemotherapy
Families & family life
Family medical history
Genes
Genomes
Li–Fraumeni syndrome
Localization
Metastasis
Mutation
Neuroendocrine tumors
Software
Tomography
TP53
Tumors
Ultrasonic imaging
Citations: Items that this one cites
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Summary:Adrenocortical carcinoma (ACC) is a rare cancer in childhood. ACC is frequently associated with germline TP53 variants, with founder effects especially due to the p.Arg337His mutation. ACC leads to the secretion of adrenocortical hormones, resulting in endocrine syndromes, which is the usual trigger for establishing the diagnosis. We present a surprising ACC pathology in a non-secreting, ectopic retroperitoneal tumour in a 4-year-old boy, successfully controlled with chemotherapy and mitotane after microscopically incomplete tumour resection with spillage. Genomic analysis (gene panel sequencing and copy-number microarray) demonstrated a novel p.Phe338Leu tetramerisation domain (TD) TP53 variant in the proband and his cancer-free mother and a monoallelic deletion encompassing the TP53 locus in cancer tissue, consistent with cancer-predisposition syndrome. While the recurrent p.Arg337His variant translates into high ACC risk, residue 338 and, in general, TD domain variants drive heterogeneous clinical scenarios, despite generally being considered less disruptive than TP53 DNA-binding domain mutations.
ISSN:2227-9067
2227-9067
DOI:10.3390/children10111793