Incidental finding of APC deletion in a child: double trouble or double chance? – a case report

Italian Journal of Pediatrics

Alessandra Carnevali¹  Rosamaria Silipigni²  Silvana Guerneri²  Berardo Rinaldi³  Donatella Milani³  Erica Rosina³  Paola Giovanna Marchisio⁴  Giovanna Gattuso⁵  Luca Bergamaschi⁵  Stefano Signoroni⁵ 

[1] Department of Radiology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy;Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Laboratory of Medical Genetics, Milan, Italy;Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Via della Commenda, 9, 20122, Milan, Italy;Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Via della Commenda, 9, 20122, Milan, Italy;Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy;Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;

关键词: 22q11.2 deletion syndrome;    APC;    Hepatoblastoma;    DNA microarray;    Incidental finding;    Case report;   

DOI  :  10.1186/s13052-021-00969-x

来源: Springer

【 摘 要 】

Background22q11.2 deletion syndrome is one of the most common genomic disorders, characterized by the variable presence of facial dysmorphisms, congenital cardiac defects, velopharyngeal insufficiency/cleft palate, thymic hypoplasia/aplasia, immunodeficiency, parathyroid hypoplasia, developmental delay, learning disabilities, psychiatric disorders, renal, ocular, and skeletal malformations, hearing loss and laryngeal abnormalities. Chromosomal microarray (CMA) hybridization is one of the most performed diagnostic tests but as a genome wide analysis, it can point out relevant incidental copy number variations.Case presentationWe report the case of a 2-year-old boy that came to our attention for mild psychomotor delay, poor growth, and minor facial anomalies. Considering a diagnosis of 22q11.2 deletion syndrome, we performed CMA that not only confirmed our diagnosis, but also pointed out an additional de novo 5q21.3q22.2 microdeletion, encompassing APC gene. As a result of the genetic testing we enrolled the patient in a tailored surveillance protocol that enabled the early detection of a hepatoblastoma. The child underwent surgical and chemotherapic treatments with complete cancer eradication.ConclusionsThe concurrent finding of an expected result and an additional deletion of APC gene represents an example of a relevant issue about the health and ethical management of secondary findings revealed by genome-wide tests. Furthermore, this report highlights the need to develop dedicated surveillance guidelines for children with APC-related polyposis and raise the question whether to suspect and screen for APC-related conditions in cases of sporadic hepatoblastomas.

【 授权许可】

CC BY