Department of Pediatrics, Division of Pediatric Hematology and Oncology, Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso, TX, USA; El Paso Children's Hospital, El Paso, TX, USA.
Medical Genetics, Sistemas Genómicos, Paterna, Spain.
Eur J Med Genet. 2022 Nov;65(11):104600. doi: 10.1016/j.ejmg.2022.104600. Epub 2022 Aug 29.
Coffin-Siris syndrome (CSS) is a rare neurodevelopmental and multisystemic disorder with wide genetic heterogeneity and phenotypic variability caused by pathogenic variants in the BAF complex with 341 cases enrolled in the CSS/BAF-related disorders registry by 2021. Pathogenic variants of ARID1A account for 7-8% of cases with CSS phenotype. Malignancy has been previously reported in six individuals with CSS associated with BAF mutations. Two of these malignancies including one acute lymphoid leukemia and one hepatoblastoma were reported in ARID1A-associated CSS (ARID1A-CSS). Alterations in ARID1A are among the most common molecular aberrations in human cancer. Somatic deletion of 1p and specifically of 1p36.11 containing ARID1A is frequently seen in hepatoblastoma and has been associated with high-risk features. Here we report a child with CSS Phenotype and a novel de novo variant of ARID1A with hepatoblastoma. Because hepatoblastoma has an incidence of 1 per million children, the presence of hepatoblastoma in 2 of 30 known cases of ARID1A-CSS is significant. ARID1A-CSS should be included among the cancer predisposition syndromes associated with an increased risk of hepatoblastoma and tumour surveillance considered for these patients. The role of ARID1A in the pathogenesis and outcome of hepatoblastoma deserves further investigation.
Coffin-Siris 综合征(CSS)是一种罕见的神经发育和多系统疾病,具有广泛的遗传异质性和表型变异性,由 BAF 复合物中的致病性变异引起,截至 2021 年,CSS/BAF 相关疾病登记处共登记了 341 例病例。ARID1A 的致病性变异占具有 CSS 表型的病例的 7-8%。先前已有报道称,CSS 伴 BAF 突变的 6 例个体中存在恶性肿瘤。其中两种恶性肿瘤,包括一例急性淋巴细胞白血病和一例肝母细胞瘤,与 ARID1A 相关 CSS(ARID1A-CSS)相关。ARID1A 的改变是人类癌症中最常见的分子异常之一。1p 的体细胞缺失,特别是包含 ARID1A 的 1p36.11 的缺失,在肝母细胞瘤中经常发生,并与高危特征相关。在此,我们报告一例具有 CSS 表型和 ARID1A 新型从头变异的肝母细胞瘤患儿。因为肝母细胞瘤的发病率为每百万儿童 1 例,所以在已知的 30 例 ARID1A-CSS 中,有 2 例存在肝母细胞瘤,这具有显著意义。ARID1A-CSS 应被列入与肝母细胞瘤风险增加相关的癌症易感性综合征,并考虑对这些患者进行肿瘤监测。ARID1A 在肝母细胞瘤的发病机制和结局中的作用值得进一步研究。