Mismatch repair cancer syndrome explained

Synonyms:Brain tumor-polyposis syndrome, Glioma-polyposis syndrome
Mismatch repair cancer syndrome
Field:oncology

Mismatch repair cancer syndrome (MMRCS) is a cancer syndrome associated with biallelic DNA mismatch repair mutations. It is also known as Turcot syndrome (after Jacques Turcot, who described the condition in 1959) and by several other names.

In MMRCS, neoplasia typically occurs in both the gut and the central nervous system (CNS). In the large intestine, multiple colonic polyps develop; in the CNS, brain tumors.

Genetics

Under the name constitutional mismatch repair-deficiency, (CMMR-D), it has been mapped to MLH1, MSH2, MSH6 or PMS2.[1] Monoallelic mutations of these genes are observed in the condition known as Lynch syndrome or hereditary nonpolyposis colorectal cancer, while biallelic mutations are observed in CMMR-D.[2] People expressing the HNPCC (which itself is considered autosomal dominant) trait are considered carriers of CMMR-D, thus CMMR-D is classified as autosomal recessive.

The term "childhood cancer syndrome" has also been proposed.[3] [4] Café-au-lait macules have been observed.[5]

Diagnosis

Childhood to early adult onset HNPCC + malignant gliomas. The polyps developed tend to be larger, fewer, and progress to malignancy earlier than those seen in familial adenomatous polyposis, a clinically similar condition with different underlying mutations. Diagnostic testing consists of a blood sample being collected, and a genetic specialist compares two copies of a patient's gene to normal MMR genes. If there are differences in the genes, the specialists are able to further test and decide if the patient has the deficiency. [6]

History

OMIM currently includes "Turcot syndrome" under Mismatch repair cancer syndrome. Turcot syndrome is the association between familial polyposis of the colon and brain tumors like medulloblastoma, malignant glioma. It was first reported by Canadian surgeon Jacques Turcot (1914-1977) et al. in 1959 and hence carries the first author's name.[7]

See also

Notes and References

  1. Kratz CP, Holter S, Etzler J, Lauten M, Pollett A, Niemeyer CM, Gallinger S, Wimmer K . Rhabdomyosarcoma in patients with constitutional mismatch-repair-deficiency syndrome . Journal of Medical Genetics . 46 . 6 . 418–20 . June 2009 . 19293170 . 10.1136/jmg.2008.064212 . 42347878 .
  2. Wimmer K, Etzler J . Constitutional mismatch repair-deficiency syndrome: have we so far seen only the tip of an iceberg? . Human Genetics . 124 . 2 . 105–22 . September 2008 . 18709565 . 10.1007/s00439-008-0542-4 . 32654505 .
  3. Krüger S, Kinzel M, Walldorf C, Gottschling S, Bier A, Tinschert S, von Stackelberg A, Henn W, Görgens H, Boue S, Kölble K, Büttner R, Schackert HK . Homozygous PMS2 germline mutations in two families with early-onset haematological malignancy, brain tumours, HNPCC-associated tumours, and signs of neurofibromatosis type 1 . European Journal of Human Genetics . 16 . 1 . 62–72 . January 2008 . 17851451 . 10.1038/sj.ejhg.5201923 . free .
  4. Tan TY, Orme LM, Lynch E, Croxford MA, Dow C, Dewan PA, Lipton L . Biallelic PMS2 mutations and a distinctive childhood cancer syndrome . Journal of Pediatric Hematology/Oncology . 30 . 3 . 254–7 . March 2008 . 18376293 . 10.1097/MPH.0b013e318161aa20 .
  5. Jackson CC, Holter S, Pollett A, Clendenning M, Chou S, Senter L, Ramphal R, Gallinger S, Boycott K . Café-au-lait macules and pediatric malignancy caused by biallelic mutations in the DNA mismatch repair (MMR) gene PMS2 . Pediatric Blood & Cancer . 50 . 6 . 1268–70 . June 2008 . 18273873 . 10.1002/pbc.21514 . 34238025 .
  6. Web site: Constitutional Mismatch Repair Deficiency Syndrome. www.stjude.org. en. 2020-03-10.
  7. Turcot J, Despres JP, St Pierre F . Malignant tumors of the central nervous system associated with familial polyposis of the colon: report of two cases . Diseases of the Colon and Rectum . 2 . 465–8 . 1959 . 13839882 . 10.1007/bf02616938. 27477524 .