title: Testing new susceptibility genes in the cohort of apparently sporadic phaeochromocytoma/paraganglioma patients with clinical characteristics of hereditary syndromes.
abstract: BACKGROUND
  Phaeochromocytoma (PCC) and paraganglioma (PGL) can occur sporadically or as a part of familial cancer syndromes. Red flags of hereditary syndromes are young age and multifocal tumours. We hypothesized that such patients are candidates for further molecular diagnosis in case of normal results in 'classical' genes.
  
  
  METHODS
  We selected patients with PCC/PGL under the age of 40 and/or with multiple tumours. First, we tested the genes RET, VHL, NF1, SDHB, SDHC and SDHD. Patients without mutations in these genes were tested for mutations in MAX, TMEM127 and SDHAF2.
  
  
  RESULTS
  In 153 patients included, mutations were detected in the classical genes in 72 patients (47%) [RET-22 (14%), VHL-13 (9%), NF1-3 (2%), SDHB-13 (9%), SDHC-3 (2%), SDHD-16 (11%), SDHB large deletions- 2 (1%)]. One patient with MAXc.223C>T (p.R75X) mutation was detected. It was a male with bilateral, metachronous phaeochromocytomas diagnosed in 36 and 40 years of age. Remarkably, he showed in the period before the MAX gene was detected, a RET p. Y791F variant. During 10-year follow-up, we did not find any thyroid abnormalities. LOH examination of tumour tissue showed somatic loss of the wild-type allele of MAX.
  
  
  CONCLUSIONS
  Analysis of the MAX gene should be performed in selected patients, especially those with bilateral adrenal phaeochromocytoma in whom mutations of the classical genes are absent. Our study provides with further support that Y791F RET is a polymorphism.
authors.affiliation: Department of Hypertension, Institute of Cardiology, Warsaw, Poland.
authors.forename: Mariola
authors.initials: M
authors.lastname: Pęczkowska
authors.forename: Aldona
authors.initials: A
authors.lastname: Kowalska
authors.forename: Jacek
authors.initials: J
authors.lastname: Sygut
authors.forename: Dariusz
authors.initials: D
authors.lastname: Waligórski
authors.forename: Angelica
authors.initials: A
authors.lastname: Malinoc
authors.forename: Hanna
authors.initials: H
authors.lastname: Janaszek-Sitkowska
authors.forename: Aleksander
authors.initials: A
authors.lastname: Prejbisz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Januszewicz
authors.forename: Hartmut P H
authors.initials: HP
authors.lastname: Neumann
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000235:genetics*; D000328:Adult; D051778:Basic Helix-Loop-Helix Leucine Zipper Transcription Factors / Q000235:genetics; D015331:Cohort Studies; D004252:DNA Mutational Analysis; D005260:Female; D020022:Genetic Predisposition to Disease; D018095:Germ-Line Mutation; D006801:Humans; D008297:Male; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000235:genetics; D009386:Neoplastic Syndromes, Hereditary / Q000235:genetics*; D010235:Paraganglioma / Q000235:genetics*; D010673:Pheochromocytoma / Q000235:genetics*; D011044:Poland; D051096:Proto-Oncogene Proteins c-ret / Q000235:genetics; D012042:Registries
chemical_list: D051778:Basic Helix-Loop-Helix Leucine Zipper Transcription Factors; C499330:MAX protein, human; D051096:Proto-Oncogene Proteins c-ret; C099282:RET protein, human