Francke U, Kung F
Med Pediatr Oncol. 1976;2(4):379-85. doi: 10.1002/mpo.2950020404.
Unilateral retinoblastoma (Rb) is usually a sporadic occurrence while bilateral (multifocal) cases are often familial. Sporadic bilateral Rb associated with a long-arm deletion of a D-group chromosome has been reported in 8 children. We have studied a 6-year-old female with bilateral sporadic retinoblastoma, treated during infancy by enucleation and radiotherapy. Chromosome banding studies on peripheral lymphocytes revealed an interstitial deletion from the long arm of a chromosome 13: del(13) (q12q14). Three additional patients reported in the literature had interstitial 13q- deletions, involving slightly different though overlapping regions. The only chromosomal region consistently missing in all of these 4 cases appears to be part of the lightly staining band 13q14. We, therefore, propose this site as the precise location of a gene (or genes) involved in retinal development. Our patient lacked features of the classic 13q- or 13-ring syndrome, which involves deletion of a more distal portion of the 13 long arm. When compared to reported patients with Rb and 13q-, it became apparent that there may be a separate recognizable syndrome consisting of moderate growth and developmental delay, characteristic facies and external ears, and bilateral sporadic Rb, which is associated with an interstitial 13q- deletion.
单侧视网膜母细胞瘤(Rb)通常是散发性的,而双侧(多灶性)病例往往具有家族性。已有报道称,8名儿童出现了与D组染色体长臂缺失相关的散发性双侧Rb。我们研究了一名6岁双侧散发性视网膜母细胞瘤女性患者,其在婴儿期接受了眼球摘除术和放射治疗。对其外周血淋巴细胞进行的染色体显带研究显示,13号染色体长臂存在中间缺失:del(13)(q12q14)。文献中报道的另外3例患者也有13q中间缺失,涉及的区域略有不同但有重叠。在所有这4例病例中始终缺失的唯一染色体区域似乎是浅染带13q14的一部分。因此,我们提出该位点是参与视网膜发育的一个基因(或多个基因)的精确位置。我们的患者没有典型的13q-或13环综合征的特征,该综合征涉及13号长臂更远端部分的缺失。与报道的患有Rb和13q-的患者相比,很明显可能存在一种单独的可识别综合征,其特征为中度生长发育迟缓、特征性面容和外耳,以及与13q中间缺失相关的双侧散发性Rb。