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A Japanese patient with Li-Fraumeni syndrome who had nine primary malignancies associated with a germline mutation of the p53 tumor-suppressor gene

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Abstract

We describe a patient who had nine primary malignant tumors and a germline mutation in the p53 tumor-suppressor gene, characteristically found in the Li-Fraumeni syndrome (LFS). A 15-year-old girl with no family history of cancer was referred to our hospital because of pain and swelling of the right knee. Osteosarcoma was diagnosed. The patient received chemotherapy followed by surgery and had a remission. After the age of 28 years, nine primary malignant tumors developed successively, including right breast cancer, colon cancer, malignant fibrous histiocytoma (MFH) of the abdominal wall, right lung double cancers, bilateral breast cancers, and MFH of the left thigh. This is the second highest number of types of primary malignant tumors to be reported in LFS. All tumors were treated by a multidisciplinary approach, including surgery. Genetic analysis revealed a germline missense mutation in the p53 gene (c.659 A > G), resulting in Y220C, which has been reported in three families with LFS. The patient died of lung metastasis from MFH at the age of 37 years. Despite the multiple tumors, repeated induction of remissions resulted in long survival. Our findings suggest that a multidisciplinary approach to treatment, including surgery, is beneficial in patients with LFS.

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References

  1. Li FP, Fraumeni JF (1969) Soft-tissue sarcomas, breast cancer, and other neoplasms. A familial syndrome? Ann Intern Med 71:747–752

    PubMed  CAS  Google Scholar 

  2. Li FP, Fraumeni JF (1982) Prospective study of a family cancer syndrome. JAMA 247:2692–2694

    Article  PubMed  CAS  Google Scholar 

  3. Li FP, Fraumeni JF, Mulvihill JJ, et al. (1988) A cancer family syndrome in 24 kindreds. Cancer Res 48:5358–5362

    PubMed  CAS  Google Scholar 

  4. Birch JM, Hartley AL, Tricker KJ, et al. (1994) Prevalence and diversity of constitutional mutations in the p53 gene among 21 Li-Fraumeni families. Cancer Res 54:1298–1304

    PubMed  CAS  Google Scholar 

  5. Malkin D, Li FP, Strong LC, et al. (1990) Germline p53 mutations in a familial syndrome of breast cancer, sarcomas, and other neoplasms. Science 250:1233–1238

    Article  PubMed  CAS  Google Scholar 

  6. Varley JM, McGown G, Thorncroft M, et al. (1997) Germline mutations of TP53 in Li-Fraumeni families: an extended study of 39 families. Cancer Res 57:3245–3252

    PubMed  CAS  Google Scholar 

  7. Varley JM (2000) Germline TP53 mutations and Li-Fraumeni syndrome. Hum Mutat 2003;21:313–320

    Article  Google Scholar 

  8. The JOA Committee of Tumors (eds) (2000) General rules for clinical and pathological studies on malignant bone tumors (in Japanese). Kanehara, Tokyo, pp 51–68

    Google Scholar 

  9. Matsumoto S, Kawaguchi N, Manabe J, et al. (2002) “In situ preparation”: new surgical procedure indicated for soft-tissue sarcoma of a lower limb in close proximity to major neurovascular structures. Int J Clin Oncol 7:51–56

    PubMed  Google Scholar 

  10. Beroud C, Soussi T (2003) The UMD-p53 database: new mutations and analysis tools. Hum Mutat 21:176–181

    Article  PubMed  CAS  Google Scholar 

  11. Huusko P, Castren K, Launonen V, et al. (1999) Germline TP53 mutations in Finnish cancer families exhibiting features of the Li-Fraumeni syndrome and negative for BRCA1 and BRCA2. Cancer Genet Cytogenet 112:9–14

    Article  PubMed  CAS  Google Scholar 

  12. Zuou XP, Sanson M, Hoang-Xuan K, et al. (1999) Germ-line mutations of p53 but not p16/CDKN2 or PTEN/MMAC1 tumor suppressor genes predispose to gliomas. Ann Neurol 46:913–916

    Article  Google Scholar 

  13. Nutting C, Camplejohn RS, Gilchrist R, et al. (2000) A patient with 17 primary tumours and a germ line mutation in TP53: tumour induction by adjuvant therapy? Clin Oncol (R Coll Radiol) 12: 300–304

    CAS  Google Scholar 

  14. Fayette J, Blay JY (2005) Genetic predictors for drug resistance in soft tissue sarcoma: a review of publications in 2004. Curr Opin Oncol 17:370–375

    Article  PubMed  Google Scholar 

  15. Cuddihy AR, Bristow RG (2004) The protein family and radiation sensitivity: yes or no? Cancer Metastasis Rev 23:237–257

    Article  PubMed  CAS  Google Scholar 

  16. Hisada M, Garber JE, Fung CY, et al. (1998) Multiple primary cancers in families with Li-Fraumeni syndrome. J Natl Cancer Inst 90:606–611

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Naohiro Izawa.

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Izawa, N., Matsumoto, S., Manabe, J. et al. A Japanese patient with Li-Fraumeni syndrome who had nine primary malignancies associated with a germline mutation of the p53 tumor-suppressor gene. Int J Clin Oncol 13, 78–82 (2008). https://doi.org/10.1007/s10147-007-0692-8

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  • DOI: https://doi.org/10.1007/s10147-007-0692-8

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