title: Genome-wide paternal uniparental disomy as a cause of Beckwith-Wiedemann syndrome associated with recurrent virilizing adrenocortical tumors.
abstract: Beckwith-Wiedemann syndrome (BWS) is an overgrowth syndrome characterized by fetal macrosomia, macroglossia, and abdominal wall defects. BWS patients are at risk to develop Wilms tumor, neuroblastoma, hepatoblastoma, and adrenal tumors. A young woman with BWS features, but with inconclusive genetic evidence for the disease, came to clinical observation for signs of virilization at the age of 16 years. An adrenocortical tumor was diagnosed and surgically resected. The tumor underwent 2 local relapses that were also surgically treated. The patient was also operated to remove a breast fibroadenoma. SNP arrays were used to analyze chromosome abnormalities in normal and tumor samples from the patient and her parents. The patient presented genome-wide mosaic paternal uniparental disomy (patUPD) both in the adrenocortical and the breast tumors, with different degrees of loss of heterozygosity (LOH). The more recent relapses of the adrenocortical tumor showed a loss of part of chromosome 17p that was absent in the first tumor. Analysis of a skin biopsy sample also showed mosaic patUPD with partial LOH, while no LOH was detected in leukocyte DNA. This case shows that virilizing adrenocortical tumors may be a clinical feature of patients with BWS. The SNP array technology is useful to diagnose genome-wide patUPD mosaicism in BWS patients with an inconclusive molecular diagnosis and underlines the tumorigenic potential of the absence of the maternal genome combined with an excess of the paternal genome.
authors.affiliation: Department of Endocrinology, CHU Reims, Hôpital Robert Debré, Reims, France.
authors.forename: F
authors.initials: F
authors.lastname: Bertoin
authors.affiliation: Programme Cartes d'Identité des Tumeurs, Ligue Nationale contre le Cancer, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Letouzé
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Grignani
authors.affiliation: Department of Pathology, CHU Reims, Hôpital Robert Debré, Reims, France.
authors.forename: M
authors.initials: M
authors.lastname: Patey
authors.affiliation: Laboratory of Endocrine Functional Explorations, APHP, Hôpital Armand Trousseau, INSERM UMRS 938 Team 4, Université Pierre et Marie Curie-Paris, Faculté de Médecine, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Rossignol
authors.affiliation: Department of Endocrinology-Metabolism-Cancer, APHP, Institut Cochin, Université Paris V-René Descartes, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Libé
authors.affiliation: Service of Diabetology, Hospital of Troyes, Troyes, France.
authors.forename: C
authors.initials: C
authors.lastname: Pasqual
authors.affiliation: Department of Endocrine Surgery, CHU Reims, Hôpital Robert Debré, Reims, France.
authors.forename: S
authors.initials: S
authors.lastname: Lardière-Deguelte
authors.affiliation: Department of Radiology, CHU Reims, Hôpital Robert Debré, Reims, France.
authors.forename: C
authors.initials: C
authors.lastname: Hoeffel-Fornes
authors.affiliation: Department of Genetics, CHU Reims, Hôpital Robert Debré, Reims, France.
authors.forename: D
authors.initials: D
authors.lastname: Gaillard
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Previderè
authors.affiliation: Department of Endocrinology, CHU Reims, Hôpital Robert Debré, Reims, France.
authors.forename: B
authors.initials: B
authors.lastname: Delemer
authors.affiliation: Institut de Pharmacologie Moléculaire et Cellulaire, CNRS UMR7275, Sophia Antipolis-Valbonne, France.
authors.forename: E
authors.initials: E
authors.lastname: Lalli
mesh_terms: D000293:Adolescent; D000306:Adrenal Cortex Neoplasms / Q000235:genetics*; D001506:Beckwith-Wiedemann Syndrome / Q000235:genetics*; D005260:Female; D006628:Hirsutism / Q000235:genetics; D006801:Humans; D020641:Polymorphism, Single Nucleotide; D024182:Uniparental Disomy; D014770:Virilism / Q000235:genetics*; D055815:Young Adult