Inherited germline TP53 mutation encodes a protein with an aberrant C-terminal motif in a case of pediatric adrenocortical tumor.
Childhood adrenocortical tumor (ACT), a very rare malignancy, has an annual worldwide incidence of about 0.3 per million children younger than 15 years. The association between inherited germline mutations of the TP53 gene and an increased predisposition to ACT was described in the context of the Li-Fraumeni syndrome. In fact, about two-thirds of children with ACT have a TP53 mutation. However, less than 10% of pediatric ACT cases occur in Li-Fraumeni syndrome, suggesting that inherited low-penetrance TP53 mutations play an important role in pediatric adrenal cortex tumorigenesis. We identified a novel inherited germline TP53 mutation affecting the acceptor splice site at intron 10 in a child with an ACT and no family history of cancer. The lack of family history of cancer and previous information about the carcinogenic potential of the mutation led us to further characterize it. Bioinformatics analysis showed that the non-natural and highly hydrophobic C-terminal segment of the frame-shifted mutant p53 protein may disrupt its tumor suppressor function by causing misfolding and aggregation. Our findings highlight the clinical and genetic counseling dilemmas that arise when an inherited TP53 mutation is found in a child with ACT without relatives with Li-Fraumeni-component tumors.
International Outreach Program, St. Jude Children's Research Hospital, Memphis, TN, 38105-3678, USA. emilia.pinto@stjude.org
Emilia M
EM
Pinto
Raul C
RC
Ribeiro
Gad B
GB
Kletter
John P
JP
Lawrence
Jesse J
JJ
Jenkins
Jinling
J
Wang
Sheila
S
Shurtleff
Lisa
L
McGregor
Richard W
RW
Kriwacki
Gerard P
GP
Zambetti
D000306:Adrenal Cortex Neoplasms / Q000235:genetics* / Q000473:pathology; D002675:Child, Preschool; D005260:Female; D016368:Frameshift Mutation / Q000235:genetics*; D020022:Genetic Predisposition to Disease; D018095:Germ-Line Mutation / Q000235:genetics*; D006801:Humans; D011379:Prognosis; D017510:Protein Folding; D017434:Protein Structure, Tertiary; D022821:RNA Splice Sites / Q000235:genetics*; D016159:Tumor Suppressor Protein p53 / Q000235:genetics*
D022821:RNA Splice Sites; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53