Concordance for neuroblastoma in monozygotic twins: case report and review of the literature.
The patients were infant male twins born by cesarean delivery following a healthy pregnancy at 36 weeks' gestation to unrelated parents. At 4 months of age, twin 2 presented with hepatomegaly and a right suprarenal mass. Resection of an adrenal tumor and a liver tumor biopsy were performed. Twin 1 had no symptoms at 4 months of age. Screening by abdominal ultrasonography showed multiple masses in the liver but no adrenal mass. Metaiodobenzylguanidine scintigraphy showed positive findings in multiple liver masses. A laparoscopic biopsy for a liver tumor was performed. All primary tumor and liver tumor specimens from twin 2 and the liver tumor of twin 1 had the same histologic classification of neuroblastoma and nearly identical genetic aberrations, including a chromosome gain or loss using array-comparative genomic hybridization. From these clinical and pathologic findings and genetic analyses, we strongly demonstrate the transplacental metastatic spread from twin 2 to twin 1. In the literature, 9 pairs of concordant twin neuroblastomas, including the current twin, have been presented; and the clinical findings of 5 twin pairs may represent placental metastases from one twin with congenital neuroblastoma to the other twin. This study is the first report presenting the possibility of twin-to-twin metastasis in monozygotic twins with neuroblastoma based on an analysis of the clinical features and genetic aberrations.
Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. taji@pedsurg.med.kyushu-u.ac.jp
Tatsuro
T
Tajiri
Ryota
R
Souzaki
Yoshiaki
Y
Kinoshita
Sakura
S
Tanaka
Yuhki
Y
Koga
Aiko
A
Suminoe
Toshiro
T
Hara
Kenichi
K
Kohashi
Yoshinao
Y
Oda
Kouji
K
Masumoto
Miki
M
Ohira
Akira
A
Nakagawara
Tomoaki
T
Taguchi
D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000196:embryology* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D000315:Adrenalectomy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002869:Chromosome Aberrations; D003131:Combined Modality Therapy; D055028:Comparative Genomic Hybridization; D003520:Cyclophosphamide / Q000008:administration & dosage; D004200:Diseases in Twins / Q000196:embryology* / Q000453:epidemiology / Q000235:genetics; D005260:Female; D005330:Fetofetal Transfusion; D006801:Humans; D007223:Infant; D007457:Iodine Radioisotopes; D008113:Liver Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D009447:Neuroblastoma / Q000737:chemistry / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000196:embryology* / Q000453:epidemiology / Q000235:genetics / Q000556:secondary* / Q000601:surgery; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011877:Radionuclide Imaging; D014430:Twins, Monozygotic; D014463:Ultrasonography; D014750:Vincristine / Q000008:administration & dosage
D007457:Iodine Radioisotopes; D019797:3-Iodobenzylguanidine; D014750:Vincristine; D003520:Cyclophosphamide