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与既往研究相比,具有意义未明变异的类肿瘤性脑病变:一例报告

Tumor-Like Brain Lesions Associated With Variants of Uncertain Significance Compared to Previous Studies: A Case Report.

作者信息

Santellán-Hernández José Omar, Romero-Luna Gerardo, Ramírez-Cruz Jacqueline, Aguilar-Hidalgo Keren Magaly, Mejía-Pérez Sonia Iliana

机构信息

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.

出版信息

Cureus. 2022 Jul 14;14(7):e26844. doi: 10.7759/cureus.26844. eCollection 2022 Jul.

DOI:10.7759/cureus.26844
PMID:35974842
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9375516/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce64/9375516/929e3368a651/cureus-0014-00000026844-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce64/9375516/c5cb526e483f/cureus-0014-00000026844-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce64/9375516/17ab1ee99aef/cureus-0014-00000026844-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce64/9375516/929e3368a651/cureus-0014-00000026844-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce64/9375516/c5cb526e483f/cureus-0014-00000026844-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce64/9375516/17ab1ee99aef/cureus-0014-00000026844-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce64/9375516/929e3368a651/cureus-0014-00000026844-i03.jpg

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本文引用的文献

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Neuroimaging Findings in Retinal Vasculopathy with Cerebral Leukoencephalopathy and Systemic Manifestations.伴有脑白质病和全身表现的视网膜血管病的神经影像学表现。
AJNR Am J Neuroradiol. 2021 Sep;42(9):1604-1609. doi: 10.3174/ajnr.A7194. Epub 2021 Jun 24.
2
Serial magnetic resonance imaging changes of pseudotumor lesions in retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations: a case report.视网膜血管病伴脑白质病和全身表现的假性肿瘤病变的连续磁共振成像改变:病例报告。
BMC Neurol. 2021 Jun 9;21(1):219. doi: 10.1186/s12883-021-02250-4.
3
Novel de novo TREX1 mutation in a patient with retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations mimicking demyelinating disease.
患者视网膜血管病变伴脑白质病和全身表现类似于脱髓鞘疾病,存在新型从头 TREX1 突变。
Mult Scler Relat Disord. 2021 Jul;52:103015. doi: 10.1016/j.msard.2021.103015. Epub 2021 May 7.
4
TREX1-associated retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations.伴有脑白质脑病和全身表现的与TREX1相关的视网膜血管病变
Clin Exp Ophthalmol. 2020 Dec;48(9):1307-1310. doi: 10.1111/ceo.13872. Epub 2020 Oct 21.
5
TREX1 - Apex predator of cytosolic DNA metabolism.TREX1 - 细胞质 DNA 代谢的顶级掠食者。
DNA Repair (Amst). 2020 Oct;94:102894. doi: 10.1016/j.dnarep.2020.102894. Epub 2020 Jun 12.
6
Retinal vasculopathy with cerebral leukoencephalopathy (RVCL): A rare mimic of tumefactive MS.视网膜血管病变伴脑白质病(RVCL):一种罕见的肿块样多发性硬化症模拟疾病。
Neurology. 2018 Oct 9;91(15):e1423-e1428. doi: 10.1212/WNL.0000000000006329. Epub 2018 Sep 7.
7
TREX1 is expressed by microglia in normal human brain and increases in regions affected by ischemia.TREX1 由正常人大脑中的小胶质细胞表达,并在受缺血影响的区域增加。
Brain Pathol. 2018 Nov;28(6):806-821. doi: 10.1111/bpa.12626. Epub 2018 Oct 10.
8
Phenotypic Variability in a Mexican Mestizo Family with Retinal Vasculopathy with Cerebral Leukodystrophy and TREX1 Mutation p.V235Gfs*6.一个患有视网膜血管病变伴脑白质营养不良和TREX1基因p.V235Gfs*6突变的墨西哥混血家族中的表型变异性。
Rev Invest Clin. 2018;70(2):68-75. doi: 10.24875/RIC.18002492.
9
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