Santellán-Hernández José Omar, Romero-Luna Gerardo, Ramírez-Cruz Jacqueline, Aguilar-Hidalgo Keren Magaly, Mejía-Pérez Sonia Iliana
Neurosurgical Oncology Department, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX.
Radio-Neurosurgery Department, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Mexico City, MEX.
Cureus. 2022 Jul 14;14(7):e26844. doi: 10.7759/cureus.26844. eCollection 2022 Jul.
TREX1 is a gene that encodes an exonuclease on the C-terminal strand at the 3 ́ end for DNA repair. Multiple syndromes associated with the alteration of this gene have been described, focusing in this case on retinal vasculopathy with cerebral leukodystrophy (RVCL). We present the case of a 44-year-old female patient with a familial history of cerebral pseudotumors. At the time of diagnosis, the patient presented weakness in the lower limbs and dysesthesias of the right body at the beginning of the clinical picture, without visual alterations or retinal changes at fundus examination. A cranial magnetic resonance imaging (MRI) study showed a pseudotumoral lesion at the inferior frontal gyrus with a report of a choline peak in spectroscopy, ring enhancement in contrasted T1 sequence, and apparent central necrosis. A molecular study shows a mutation in c2136G>A, c.799dup, and c.5312A>G related to genes expressing PDE6A, TREX1, and VCAN proteins, respectively, mutations that have not been previously reported.
TREX1是一种基因,它在3'端的C末端链上编码一种用于DNA修复的核酸外切酶。已经描述了多种与该基因改变相关的综合征,在这种情况下主要关注伴有脑白质营养不良的视网膜血管病变(RVCL)。我们报告了一例44岁女性患者,其有脑假瘤家族史。在诊断时,患者在临床表现开始时出现下肢无力和右侧身体感觉异常,眼底检查未发现视力改变或视网膜变化。头颅磁共振成像(MRI)研究显示额下回有一个假瘤样病变,光谱检查报告有胆碱峰,对比T1序列有环形强化,且有明显的中央坏死。分子研究显示分别与表达PDE6A、TREX1和VCAN蛋白的基因相关的c2136G>A、c.799dup和c.5312A>G突变,这些突变此前尚未见报道。