Agenesis of the corpus callosum and gray matter heterotopia in three patients with constitutional mismatch repair deficiency syndrome

Annette F. Baas, Michael Gabbett, Milan Rimac, Minttu Kansikas, Martine Raphael, Rutger A J Nievelstein, Wayne Nicholls, Johan Offerhaus, Danielle Bodmer, Annekatrin Wernstedt, Birgit Krabichler, Ulrich Strasser, Minna Nyström, Johannes Zschocke, Stephen P. Robertson, Mieke M. Van Haelst, Katharina Wimmer

Research output: Contribution to journalArticlepeer-review

Abstract

Constitutional mismatch repair deficiency (CMMR-D) syndrome is a rare inherited childhood cancer predisposition caused by biallelic germline mutations in one of the four mismatch repair (MMR)-genes, MLH1, MSH2, MSH6 or PMS2. Owing to a wide tumor spectrum, the lack of specific clinical features and the overlap with other cancer predisposing syndromes, diagnosis of CMMR-D is often delayed in pediatric cancer patients. Here, we report of three new CMMR-D patients all of whom developed more than one malignancy. The common finding in these three patients is agenesis of the corpus callosum (ACC). Gray matter heterotopia is present in two patients. One of the 57 previously reported CMMR-D patients with brain tumors (therefore all likely had cerebral imaging) also had ACC. With the present report the prevalence of cerebral malformations is at least 4/60 (6.6%). This number is well above the population birth prevalence of 0.09-0.36 live births with these cerebral malformations, suggesting that ACC and heterotopia are features of CMMR-D. Therefore, the presence of cerebral malformations in pediatric cancer patients should alert to the possible diagnosis of CMMR-D. ACC and gray matter heterotopia are the first congenital malformations described to occur at higher frequency in CMMR-D patients than in the general population. Further systematic evaluations of CMMR-D patients are needed to identify possible other malformations associated with this syndrome.

Original languageEnglish (US)
Pages (from-to)55-61
Number of pages7
JournalEuropean Journal of Human Genetics
Volume21
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

Keywords

  • agenesis of corpus callosum
  • biallelic germline mutation
  • childhood cancer
  • constitutional mismatch repair deficiency syndrome
  • gray matter heterotopia

ASJC Scopus subject areas

  • Genetics(clinical)
  • Genetics

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