Broadening the spectrum of SMARCB1-associated malignant tumors: a case of uterine leiomyosarcoma in a patient with schwannomatosis

Hum Pathol. 2015 Aug;46(8):1226-31. doi: 10.1016/j.humpath.2015.04.008. Epub 2015 May 6.

Abstract

Schwannomatosis is a tumor predisposition syndrome characterized by development of multiple intracranial, spinal, and peripheral schwannomas. Constitutional alterations in either SMARCB1 or LZTR1 on 22q are responsible of the phenotype. We describe a 34-year-old woman who developed multiple benign peripheral sheath tumors and a uterine leiomyosarcoma. The patient carried a de novo constitutional alteration in exon 8 of SMARCB1, c.1118G > A, which destroyed the splice donor site of intron 8. Two schwannomas and the leiomyosarcoma of the patient retained the SMARCB1 mutation; in addition, the tumors showed loss of the normal chromosome 22. In conclusion, our findings enlarged the spectrum of SMARCB1-predisposing tumors and demonstrated, for the first time, the association of a malignant smooth muscle tumor to schwannomatosis. Therefore, clinicians should definitely be aware that a constitutional SMARCB1 mutation, which mainly predisposes to benign nerve sheath tumors, may also predispose to aggressive neoplasms throughout life, within an unexpected spectrum.

Keywords: LZTR1; Leiomyosarcoma; NF2; SMARCB1; Schwannomatosis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Chromosomal Proteins, Non-Histone / genetics*
  • DNA-Binding Proteins / genetics*
  • Female
  • Genetic Predisposition to Disease / genetics
  • Humans
  • Immunohistochemistry
  • Leiomyosarcoma / genetics*
  • Multiplex Polymerase Chain Reaction
  • Neoplasms, Multiple Primary / genetics*
  • Neurilemmoma / genetics*
  • Neurofibromatoses / genetics*
  • Polymerase Chain Reaction
  • SMARCB1 Protein
  • Skin Neoplasms / genetics*
  • Transcription Factors / genetics*
  • Uterine Neoplasms / genetics*
  • Young Adult

Substances

  • Chromosomal Proteins, Non-Histone
  • DNA-Binding Proteins
  • SMARCB1 Protein
  • SMARCB1 protein, human
  • Transcription Factors

Supplementary concepts

  • Schwannomatosis