Somatic BRAF c.1799T>A p.V600E Mosaicism syndrome characterized by a linear syringocystadenoma papilliferum, anaplastic astrocytoma, and ocular abnormalities

Yuko Watanabe, Kosuke Shido, Tetsuya Niihori, Hidetaka Niizuma, Yu Katata, Chie Iizuka, Daiju Oba, Kunihiko Moriya, Yuka Saito-Nanjo, Masaei Onuma, Takeshi Rikiishi, Yoji Sasahara, Mika Watanabe, Setsuya Aiba, Ryuta Saito, Yukihiko Sonoda, Teiji Tominaga, Yoko Aoki, Shigeo Kure

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Genetic mosaicism for somatic mutations of oncogenes is common in genodermatoses, which can be complicated with extra-cutaneous abnormalities. Here we describe an infant with a congenital anaplastic astrocytoma, a linear syringocystadenoma papilliferum, and ocular abnormalities. The BRAF c.1799T>A p.V600E mutation was detected in both the brain and skin tumor cells but not in the blood or normal skin cells, suggesting somatic mosaicsism for the mutation. Clinically, the brain tumor gradually became life threatening without any response to conventional chemotherapies including carboplatin, etoposide, and temozolomide. Vemurafenib, a BRAF p.V600E inhibitor, was administered daily after the detection of the BRAF mutation. This single-agent therapy was dramatically effective against the anaplastic astrocytoma; the tumor regressed, the cerebrospinal fluid cell count and protein levels decreased to normal levels, and hydrocephalus resolved. Moreover, other lesions including a corneal cyst also responded to vemurafenib. The brain tumor continued shrinking after 6 months of treatment. We present a genodermatosis syndrome associated with BRAF c.1799T>A p.V600E mosaicism. This syndrome may represent a new entity in the mosaic RASopathies, partly overlapping with Schimmelpenning-Feuerstein-Mims syndrome, which is driven by mosaicism of HRAS and/or KRAS activating mutations. Screening for BRAF c.1799T>A p.V600E is especially useful for those with malignant tumors, because it is one of the most-druggable targets.

Original languageEnglish
Pages (from-to)189-194
Number of pages6
JournalAmerican Journal of Medical Genetics, Part A
Volume170
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

Keywords

  • Anaplastic astrocytoma
  • BRAF c.1799T>A p.V600E
  • Schimmelpenning-Feuerstein-Mims syndrome
  • Vemurafenib

ASJC Scopus subject areas

  • Genetics
  • Genetics(clinical)

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