Difference between revisions of "Hereditary leiomyomatosis and renal cell carcinoma syndrome"

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(formal criteria for HLRCC)
 
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Characteristics:
Characteristics:
* [[Hereditary leiomyomatosis and renal cell carcinoma syndrome-associated renal cell carcinoma]].
* [[Fumarate hydratase-deficient renal cell carcinoma]].
* Benign [[leiomyoma]]s skin/[[uterine leiomyoma|uterus]].
* Benign [[leiomyoma]]s skin/[[uterine leiomyoma|uterus]].
* Uterine [[leiomyosarcoma]].
* Uterine [[leiomyosarcoma]].


==Formal criteria==
==Formal criteria==
The diagnosis of the HLRCC syndrome requires that:<ref>{{Cite journal  | last1 = Adam | first1 = MP. | last2 = Ardinger | first2 = HH. | last3 = Pagon | first3 = RA. | last4 = Wallace | first4 = SE. | last5 = Bean | first5 = LJH. | last6 = Mefford | first6 = HC. | last7 = Stephens | first7 = K. | last8 = Amemiya | first8 = A. | last9 = Ledbetter | first9 = N. | title = Hereditary Leiomyomatosis and Renal Cell Cancer | journal =  | volume =  | issue =  | pages =  | month =  | year =  | doi =  | PMID = 20301430 }}</ref>
The diagnosis of the HLRCC syndrome requires both #1 and #2:<ref>{{Cite journal  | last1 = Adam | first1 = MP. | last2 = Ardinger | first2 = HH. | last3 = Pagon | first3 = RA. | last4 = Wallace | first4 = SE. | last5 = Bean | first5 = LJH. | last6 = Mefford | first6 = HC. | last7 = Stephens | first7 = K. | last8 = Amemiya | first8 = A. | last9 = Ledbetter | first9 = N. | title = Hereditary Leiomyomatosis and Renal Cell Cancer | journal =  | volume =  | issue =  | pages =  | month =  | year =  | doi =  | PMID = 20301430 }}</ref>
#A pathogenic FH mutation is present by molecular testing.
#A pathogenic FH mutation is present by molecular testing.
#One of the following (pathologic) findings:
#One of the following (pathologic) findings:
#*Multiple cutaneous leiomyoma where one was proven histologically.
#*Multiple cutaneous leiomyoma where one was proven histologically.
#*One cutaneous leiomyoma in the context of a family history of HRLCC.
#*One cutaneous leiomyoma in the context of a family history of HLRCC.
#*RCC with a morphology suggestive of HRLCC syndrome-associated RCC
#*RCC with a morphology suggestive of HRLCC syndrome-associated RCC.


==General==
==General==
*Autosomal dominant inheritance<ref name=pmid17895761>{{Cite journal  | last1 = Merino | first1 = MJ. | last2 = Torres-Cabala | first2 = C. | last3 = Pinto | first3 = P. | last4 = Linehan | first4 = WM. | title = The morphologic spectrum of kidney tumors in hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome. | journal = Am J Surg Pathol | volume = 31 | issue = 10 | pages = 1578-85 | month = Oct | year = 2007 | doi = 10.1097/PAS.0b013e31804375b8 | PMID = 17895761 }}</ref> with variable penetration.<ref name=pmid24309325>{{Cite journal  | last1 = Reyes | first1 = C. | last2 = Karamurzin | first2 = Y. | last3 = Frizzell | first3 = N. | last4 = Garg | first4 = K. | last5 = Nonaka | first5 = D. | last6 = Chen | first6 = YB. | last7 = Soslow | first7 = RA. | title = Uterine smooth muscle tumors with features suggesting fumarate hydratase aberration: detailed morphologic analysis and correlation with S-(2-succino)-cysteine immunohistochemistry. | journal = Mod Pathol | volume = 27 | issue = 7 | pages = 1020-7 | month = Jul | year = 2014 | doi = 10.1038/modpathol.2013.215 | PMID = 24309325 }}</ref>
*Autosomal dominant inheritance<ref name=pmid17895761>{{Cite journal  | last1 = Merino | first1 = MJ. | last2 = Torres-Cabala | first2 = C. | last3 = Pinto | first3 = P. | last4 = Linehan | first4 = WM. | title = The morphologic spectrum of kidney tumors in hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome. | journal = Am J Surg Pathol | volume = 31 | issue = 10 | pages = 1578-85 | month = Oct | year = 2007 | doi = 10.1097/PAS.0b013e31804375b8 | PMID = 17895761 }}</ref> with variable penetration.<ref name=pmid24309325>{{Cite journal  | last1 = Reyes | first1 = C. | last2 = Karamurzin | first2 = Y. | last3 = Frizzell | first3 = N. | last4 = Garg | first4 = K. | last5 = Nonaka | first5 = D. | last6 = Chen | first6 = YB. | last7 = Soslow | first7 = RA. | title = Uterine smooth muscle tumors with features suggesting fumarate hydratase aberration: detailed morphologic analysis and correlation with S-(2-succino)-cysteine immunohistochemistry. | journal = Mod Pathol | volume = 27 | issue = 7 | pages = 1020-7 | month = Jul | year = 2014 | doi = 10.1038/modpathol.2013.215 | PMID = 24309325 }}</ref>
**In one series of 21 families: 62% had renal cancer, 76% had cutaneous leiomyomas and 100% had [[uterine leiomyoma]]s.<ref name=pmid16597677>{{Cite journal  | last1 = Pithukpakorn | first1 = M. | last2 = Wei | first2 = MH. | last3 = Toure | first3 = O. | last4 = Steinbach | first4 = PJ. | last5 = Glenn | first5 = GM. | last6 = Zbar | first6 = B. | last7 = Linehan | first7 = WM. | last8 = Toro | first8 = JR. | title = Fumarate hydratase enzyme activity in lymphoblastoid cells and fibroblasts of individuals in families with hereditary leiomyomatosis and renal cell cancer. | journal = J Med Genet | volume = 43 | issue = 9 | pages = 755-62 | month = Sep | year = 2006 | doi = 10.1136/jmg.2006.041087 | PMID = 16597677 }}</ref>
**In one series of 21 families: 62% had renal cancer, 76% had cutaneous leiomyomas and 100% had [[uterine leiomyoma]]s.<ref name=pmid15937070>{{Cite journal  | last1 = Wei | first1 = MH. | last2 = Toure | first2 = O. | last3 = Glenn | first3 = GM. | last4 = Pithukpakorn | first4 = M. | last5 = Neckers | first5 = L. | last6 = Stolle | first6 = C. | last7 = Choyke | first7 = P. | last8 = Grubb | first8 = R. | last9 = Middelton | first9 = L. | title = Novel mutations in FH and expansion of the spectrum of phenotypes expressed in families with hereditary leiomyomatosis and renal cell cancer. | journal = J Med Genet | volume = 43 | issue = 1 | pages = 18-27 | month = Jan | year = 2006 | doi = 10.1136/jmg.2005.033506 | PMID = 15937070 }}</ref>


Features - clinical:
Features - clinical:
*[[Leiomyoma]]s - high penetrance.
*[[Leiomyoma]]s - high penetrance.
**Manifestation: skin rash.<ref name=pmid24999901>{{Cite journal  | last1 = Toon | first1 = CW. | last2 = Hasovits | first2 = C. | last3 = Paik | first3 = J. | last4 = Field | first4 = M. | last5 = Chou | first5 = A. | last6 = Hugh | first6 = TJ. | last7 = Pavlakis | first7 = N. | last8 = Gill | first8 = AJ. | title = Skin rash, a kidney mass and a family mystery dating back to World War II. | journal = Med J Aust | volume = 201 | issue = 1 | pages = 58-60 | month = Jul | year = 2014 | doi =  | PMID = 24999901 }}</ref>
**Manifestation: skin rash.<ref name=pmid24999901>{{Cite journal  | last1 = Toon | first1 = CW. | last2 = Hasovits | first2 = C. | last3 = Paik | first3 = J. | last4 = Field | first4 = M. | last5 = Chou | first5 = A. | last6 = Hugh | first6 = TJ. | last7 = Pavlakis | first7 = N. | last8 = Gill | first8 = AJ. | title = Skin rash, a kidney mass and a family mystery dating back to World War II. | journal = Med J Aust | volume = 201 | issue = 1 | pages = 58-60 | month = Jul | year = 2014 | doi =  | PMID = 24999901 }}</ref>
**Involvement may be minimal or extensive.<ref name=pmid16597677/>
**Involvement may be minimal or extensive.<ref name=pmid15937070/>
*[[Hereditary leiomyomatosis and renal cell carcinoma syndrome-associated renal cell carcinoma]].
*[[Hereditary leiomyomatosis and renal cell carcinoma syndrome-associated renal cell carcinoma]].
**Often aggressive and significant cause of mortality.<ref name=pmid24441663>{{Cite journal  | last1 = Chen | first1 = YB. | last2 = Brannon | first2 = AR. | last3 = Toubaji | first3 = A. | last4 = Dudas | first4 = ME. | last5 = Won | first5 = HH. | last6 = Al-Ahmadie | first6 = HA. | last7 = Fine | first7 = SW. | last8 = Gopalan | first8 = A. | last9 = Frizzell | first9 = N. | title = Hereditary leiomyomatosis and renal cell carcinoma syndrome-associated renal cancer: recognition of the syndrome by pathologic features and the utility of detecting aberrant succination by immunohistochemistry. | journal = Am J Surg Pathol | volume = 38 | issue = 5 | pages = 627-37 | month = May | year = 2014 | doi = 10.1097/PAS.0000000000000163 | PMID = 24441663 }}</ref>
**Often aggressive and significant cause of mortality.<ref name=pmid24441663>{{Cite journal  | last1 = Chen | first1 = YB. | last2 = Brannon | first2 = AR. | last3 = Toubaji | first3 = A. | last4 = Dudas | first4 = ME. | last5 = Won | first5 = HH. | last6 = Al-Ahmadie | first6 = HA. | last7 = Fine | first7 = SW. | last8 = Gopalan | first8 = A. | last9 = Frizzell | first9 = N. | title = Hereditary leiomyomatosis and renal cell carcinoma syndrome-associated renal cancer: recognition of the syndrome by pathologic features and the utility of detecting aberrant succination by immunohistochemistry. | journal = Am J Surg Pathol | volume = 38 | issue = 5 | pages = 627-37 | month = May | year = 2014 | doi = 10.1097/PAS.0000000000000163 | PMID = 24441663 }}</ref>
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Note:
Note:
*The RCC in the past was typically diagnosed as ''[[papillary renal cell carcinoma]]''.<ref name=Ref_WMSP290>{{Ref WMSP|290}}</ref>
*The RCC in the past was typically diagnosed as ''[[papillary renal cell carcinoma]]''.<ref name=Ref_WMSP290>{{Ref WMSP|290}}</ref>
*Case reports describing an association with [[adrenal cortical carcinoma]].<ref>{{cite journal |authors=Silverman E, Addasi N, Azzawi M, Duarte EM, Huang D, Swanson B, Ganti AK, Reiser G, Fingeret AL, Kotwal A |title=Recurrent Cushing Syndrome From Metastatic Adrenocortical Carcinoma With Fumarate Hydratase Allelic Variant |journal=AACE Clin Case Rep |volume=8 |issue=6 |pages=259–263 |date=2022 |pmid=36447829 |pmc=9701913 |doi=10.1016/j.aace.2022.09.003 |url=}}</ref>


==See also==
==See also==
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