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Potential genetic anticipation in hereditary leiomyomatosis-renal cell cancer (HLRCC)

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Abstract

Hereditary leiomyomatosis-renal cell cancer (HLRCC) is an autosomal dominant disorder characterised by cutaneous leiomyomas, symptomatic uterine leiomyomas and aggressive type II papillary renal cell carcinoma. It is caused by heterozygous mutations in the fumarate hydratase (FH) gene on chromosome 1q43. We present evidence of genetic anticipation in HLRCC syndrome. A comprehensive literature review was performed to determine the potential for genetic anticipation in HLRCC syndrome. The normal random effects model was used to evaluate for genetic anticipation to ensure reduction in bias. A total of 11 FH kindreds with available multi-generational data were identified for analysis. The mean difference in age at diagnosis of RCC between the first and second generation was −18.6 years (95 % CI −26.6 to −10.6, p < 0.001). The mean difference in age at diagnosis of RCC between the first and third generation was −36.2 years (95 % CI −47.0 to −25.4, p < 0.001). No evidence of anticipation for uterine leiomyomas was observed (p = 0.349). We report preliminary evidence of genetic anticipation of RCC in HLRCC syndrome. Additional clinical validation is important to confirm this observation, which may have practical implications on counseling and timing of surveillance initiation. Exploration of the underlying mechanisms of anticipation in HLRCC would be of considerable biological interest.

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Acknowledgments

We would like to thank all our patients, and referring clinicians, particularly Dr. John Yuen and Dr. Sim Hong Gee of the Department of Urology, Singapore General Hospital.

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Authors and Affiliations

  1. Department of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore

    Mei Hua Wong, Joanne Ngeow & Min Han Tan

  2. Department of Epidemiology and Public Health, National University of Singapore, Singapore, Singapore

    Chuen Seng Tan

  3. Cancer Science Institute, National University of Singapore, Singapore, Singapore

    Soo Chin Lee & Yvonne Yong

  4. Laboratory of Interdisciplinary Urological Oncology, Van Andel Research Institute, Grand Rapids, MI, USA

    Aik Seng Ooi

  5. Institute of Bioengineering and Nanotechnology, Singapore, Singapore

    Min Han Tan

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  1. Mei Hua Wong
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  2. Chuen Seng Tan
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  3. Soo Chin Lee
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  5. Aik Seng Ooi
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  7. Min Han Tan
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Correspondence to Min Han Tan.

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Wong, M.H., Tan, C.S., Lee, S.C. et al. Potential genetic anticipation in hereditary leiomyomatosis-renal cell cancer (HLRCC). Familial Cancer 13, 281–289 (2014). https://doi.org/10.1007/s10689-014-9703-x

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  • DOI: https://doi.org/10.1007/s10689-014-9703-x

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