title: Nasal chondromesenchymal hamartomas arise secondary to germline and somatic mutations of DICER1 in the pleuropulmonary blastoma tumor predisposition disorder.
abstract: Nasal chondromesenchymal hamartoma (NCMH) is a rare nasal tumor that typically presents in young children. We previously reported on NCMH occurrence in children with pleuropulmonary blastoma (PPB), a rare pulmonary dysembryonic sarcoma that is the hallmark neoplasm in the PPB-associated DICER1 tumor predisposition disorder. Original pathologic materials from individuals with a PPB, PPB-associated tumor and/or a DICER1 mutation were centrally reviewed by the International PPB Registry. Paraffin-embedded NCMH tumor tissue was available in three cases. Laser-capture microdissection was used to isolate mesenchymal spindle cells and cartilage in one case for Sanger sequencing of DICER1. Nine patients (5F/4M) had PPB and NCMH. NCMH was diagnosed at a median age of 10 years (range 6-21 years). NCMH developed 4.5-13 years after PPB. Presenting NCMH symptoms included chronic sinusitis and nasal congestion. Five patients had bilateral tumors. Local NCMH recurrences required several surgical resections in two patients, but all nine patients were alive at 0-16 years of follow-up. Pathogenic germline DICER1 mutations were found in 6/8 NCMH patients tested. In 2 of the patients with germline DICER1 mutations, somatic DICER1 missense mutations were also identified in their NCMH (E1813D; n = 2). Three additional PPB patients developed other nasal lesions seen in the general population (a Schneiderian papilloma, chronic sinusitis with cysts, and allergic nasal polyps with eosinophils). Two of these patients had germline DICER1 mutations. Pathogenic germline and somatic mutations of DICER1 in NCMH establishes that the genetic etiology of NCMH is similar to PPB, despite the disparate biological potential of these neoplasms.
authors.affiliation: Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA, drstewart@mail.nih.gov.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Stewart
authors.forename: Yoav
authors.initials: Y
authors.lastname: Messinger
authors.forename: Gretchen M
authors.initials: GM
authors.lastname: Williams
authors.forename: Jiandong
authors.initials: J
authors.lastname: Yang
authors.forename: Amanda
authors.initials: A
authors.lastname: Field
authors.forename: Kris Ann P
authors.initials: KA
authors.lastname: Schultz
authors.forename: Laura A
authors.initials: LA
authors.lastname: Harney
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Doros
authors.forename: Louis P
authors.initials: LP
authors.lastname: Dehner
authors.forename: D Ashley
authors.initials: DA
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D053487:DEAD-box RNA Helicases / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D018095:Germ-Line Mutation; D006222:Hamartoma / Q000209:etiology / Q000235:genetics* / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000235:genetics* / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local; D009668:Nose Diseases / Q000209:etiology / Q000235:genetics* / Q000473:pathology; D018202:Pulmonary Blastoma / Q000150:complications / Q000235:genetics* / Q000473:pathology; D012042:Registries; D043244:Ribonuclease III / Q000235:genetics*; D055815:Young Adult
chemical_list: C408087:DICER1 protein, human; D043244:Ribonuclease III; D053487:DEAD-box RNA Helicases