遗传性口腔鳞状细胞癌与 CDKN2A 种系突变相关:一例报告。
Hereditary oral squamous cell carcinoma associated with CDKN2A germline mutation: a case report.
机构信息
Division of Hematology and Oncology, Department of Medicine, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093-0960, USA.
Division of Otolaryngology, Department of Surgery, University of California San Diego, La Jolla, CA, 92093, USA.
出版信息
J Otolaryngol Head Neck Surg. 2022 Feb 5;51(1):5. doi: 10.1186/s40463-022-00556-y.
BACKGROUND
Germline CDKN2A mutations are a well-known cause of familial atypical multiple mole melanoma (OMIM #155601) and melanoma-pancreatic cancer syndrome (OMIM #606719). Increased risk of head and neck squamous cell carcinoma (HNSCC), particularly oral squamous cell carcinoma (OSCC) in those with germline CDKN2A mutations, has been described. However, screening for HNSCC is not a routine practice in patients with CDKN2A germline mutations and these mutations are not a conventional test for HNSCC patients without obvious risk factors.
CASE PRESENTATION
We describe a female with no smoking history who developed oral squamous cell carcinoma at age 39 and had a complex clinical course of recurrent multifocal squamous cell carcinoma (SCC) and carcinoma in situ of the oral cavity and oropharynx. Detailed family history demonstrated that her mother was diagnosed with OSCC and melanoma in her 40 s, and her maternal grandfather was diagnosed with metastatic melanoma in his 40 s. Genetic testing of the patient and her mother revealed CDKN2A c.301G>T mutation. She was referred to genetic counseling as well as to dermatology, gastroenterology, and neurology for cancer surveillance. She was treated with resections and has no evidence of disease 3 years after diagnosis.
CONCLUSIONS
We report a family with a CDKN2A c.301 G>T mutation who also have significant history of OSCC, adding to the growing body of literature suggesting increased risk of HNSCC, particularly OSCC, in CDKN2A germline mutation carriers. It is important to consider CDKN2A mutation testing in familial HNSCC and young patients without obvious risk factors. Moreover, surveillance for HNSCC should be routine practice in those with a CDKN2A germline mutation.
背景
胚系 CDKN2A 突变是家族性非典型多发性黑素瘤(OMIM#155601)和黑色素瘤-胰腺癌综合征(OMIM#606719)的已知病因。已有报道称,胚系 CDKN2A 突变患者发生头颈部鳞状细胞癌(HNSCC),尤其是口腔鳞状细胞癌(OSCC)的风险增加。然而,在携带胚系 CDKN2A 突变的患者中,并未常规筛查 HNSCC,并且对于无明显危险因素的 HNSCC 患者,这些突变也不是常规检测。
病例介绍
我们描述了一位无吸烟史的女性,她在 39 岁时罹患口腔鳞状细胞癌,且经历了复发性多灶性鳞状细胞癌(SCC)和口腔及口咽原位癌的复杂临床病程。详细的家族史显示,其母亲在 40 多岁时被诊断为 OSCC 和黑色素瘤,其外祖父在 40 多岁时被诊断为转移性黑色素瘤。对患者及其母亲进行基因检测显示 CDKN2A c.301G>T 突变。她被转介至遗传咨询科以及皮肤科、胃肠病科和神经科进行癌症监测。她接受了切除术治疗,在诊断后 3 年无疾病证据。
结论
我们报告了一个携带 CDKN2A c.301G>T 突变的家族,且该家族有 OSCC 的显著病史,这增加了越来越多的文献表明 CDKN2A 胚系突变携带者发生 HNSCC,尤其是 OSCC 的风险增加。在家族性 HNSCC 和无明显危险因素的年轻患者中,考虑进行 CDKN2A 突变检测很重要。此外,对于携带 CDKN2A 胚系突变的患者,应常规进行 HNSCC 监测。