The first pancreatic neuroendocrine tumor in Li-Fraumeni syndrome: a case report

BMC Cancer

Donald W. Hadley¹  Mark Raffeld²  Francine Blumental De Abreu²  Liqiang Xi²  Sho Yano³  Irini Manoli³  Naris Nilubol⁴  John G. Aversa⁴  Samira M. Sadowski⁴ 

[1] Human Development Section, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health;Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health;Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health;Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health;

关键词: Pancreatic neuroendocrine tumor;    Li-Fraumeni syndrome;    TP53;    Hereditary pancreatic neoplasm;   

DOI  :  10.1186/s12885-020-06723-6

来源: DOAJ

【 摘 要 】

Abstract Background Li-Fraumeni syndrome is a cancer predisposition syndrome caused by germline TP53 tumor suppressor gene mutations, with no previous association with pancreatic neuroendocrine tumors (PNETs). Here we present the first case of PNET associated with Li-Fraumeni syndrome. Case presentation This is a 43-year-old female who underwent laparoscopic distal pancreatectomy at age 39 for a well-differentiated grade 2 cystic PNET. When the patient was 41 years old, her seven-year-old daughter was found to have an astrocytoma and a germline TP53 mutation. While undergoing surveillance with 68Gallium-DOTATATE positron emission tomography/computed tomography for her PNET, the patient was found to have a large choroid plexus papilloma in her right temporal lobe. She underwent genetic counseling and testing that identified a germline pathogenic variant in TP53, leading to the diagnosis of Li-Fraumeni syndrome. Her PNET had a hemizygous pathogenic TP53 mutation with loss of the wild-type alternate allele, consistent with loss of heterozygosity and the two-hit hypothesis. She was enrolled in a Li-Fraumeni syndrome protocol and continues surveillance screening with our service. Conclusions This is the first PNET reported in association with Li-Fraumeni syndrome. Pancreatic cancer risk is elevated in this syndrome, and our case highlights the need for vigilance in screening for pancreatic neoplasms in these patients.

【 授权许可】

Unknown