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Reed Syndrome in Eighteen Patients: A Genodermatosis Where Piloleiomyomas May Be the Diagnostic Clue

Received: 5 September 2021    Accepted: 24 September 2021    Published: 17 November 2021
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Abstract

Introduction: Hereditary leiomyomatosis and renal cell cancer (HLRCC) is caused by germline heterozygous mutations of the fumarate hydratase (FH) gene. Materials and Methods: A retrospective observational study was conducted, aimed at characterizing the clinical features, histopathology, and genetic mutations in eighteen patients with confirmed HLRCC diagnosis. Results: FH gene mutations were identified in the seven families studied, including a previously undescribed mutation. All index cases of the families included were suspected on skin manifestations. Thirteen of the 18 patients (72%) presented cutaneous leiomyomas. The chief complaint was pain, with complete but transient response to botulinum toxin in one. No evidence of malignant transformation was observed. Uterine leiomyomas were present in seven of the eight women studied (88%). There was no evidence of renal cell carcinoma in any of the patients in the study. The most frequently found mutations were missense type (43%), followed by large rearrangements (24%), intronic deletions (14%) and nonsense (14%). A novel mutation not previously described in the literature is presented. Conclusions: HLRCC is a rare disease but it is also probably underdiagnosed. Dermatologists have an essential role in its diagnosis, by recognizing the clinical characteristics of the syndrome and investigating the family history.

Published in International Journal of Clinical Dermatology (Volume 4, Issue 2)
DOI 10.11648/j.ijcd.20210402.12
Page(s) 16-22
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Piloleiomyoma, Genodermatosis, Reed Syndrome, Adnexal Tumor

References
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[2] Reed WB, Walker R, Horowitz R. Cutaneous leiomyomata with uterine leiomyomata. Acta Derm Venereol 1973; 53 (5): 409-16.
[3] Launonen V, Vierimaa O, Kiuru M et al. Inherited susceptibility to uterine leiomyomas and renal cell cancer. Proc Natl Acad Sci 2001; 98 (6): 3387-92.
[4] Patel VM, Handler MZ, Schwartz RA, Lambert WC. Hereditary leiomyomatosis and renal cell cancer syndrome: An update and review. J Am Acad Dermatol 2017; 77 (1): 149-58.
[5] Toro JR, Nickerson ML, Wei M-H et al. Mutations in the fumarate hydratase gene cause hereditary leiomyomatosis and renal cell cancer in families in North America. Am J Hum Genet 2003; 73 (1): 95-106.
[6] Smit DL, Mensenkamp AR, Badeloe S et al. Hereditary leiomyomatosis and renal cell cancer in families referred for fumarate hydratase germline mutation analysis. Clin Genet. 2011; 79: 49-59.
[7] Schmidt L, Linehan WM. Hereditary leiomyomatosis and renal cell carcinoma. Int J Nephrol Renovasc Dis 2014; 20 (7): 253-60.
[8] Almeida FT, Santos RP, Carvalho SD, Brito MC. Reed’s Syndrome. Indian J Dermatol 2018; 63 (3): 261-3.
[9] Arenas Valencia C, Rodríguez López ML, Cardona Barreto AY, Garavito Rodríguez E, Arteaga Díaz CE. Hereditary leiomyomatosis and renal cell cancer syndrome: identification and clinical characterization of a novel mutation in the FH gene in a Colombian family. Fam Cancer 2017; 16 (1): 117–22.
[10] Arenas Valencia C, Lopez Kleine L, Pinzon Velasco AM, Cardona Barreto AY, Arteaga Diaz CE. Gene expression analysis in peripheral blood cells of patients with hereditary leiomyomatosis and renal cell cancer syndrome (HLRCC): identification of NRF2 pathway activation. Fam Cancer 2018; 17 (4): 587–99.
[11] Bayley J-P, Launonen V, Tomlinson IP. The FH mutation database: an online database of fumarate hydratase mutations involved in the MCUL (HLRCC) tumor syndrome and congenital fumarase deficiency. BMC Med Genet 2008; 9 (1): 20.
[12] Plon SE, Eccles DM, Esaton D et al. Sequence variant classification and reporting: recommendations for improving interpretation of cancer susceptibility genetic test results. Hum Mutat, 2008; 29 (11): 1282-91.
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[14] Adams A, Sharpe KK, Peters P, Freeman M. Hereditary leiomyomatosis and renal cell cancer (HLRCC): cutaneous and renal manifestations requiring a multidisciplinary team approach. BMJ Case Rep 2017; 11 pii: bcr-2016-215115.
[15] Badeloe S, Frank J. Clinical and molecular genetic aspects of hereditary multiple cutaneous leiomyomatosis. Eur J Dermatol 2009; 19 (6): 545–51.
[16] Alam NA, Barclay E, Rowan AJ et al. Clinical Features of Multiple Cutaneous and Uterine Leiomyomatosis. Arch Dermatol 2005; 141 (2): 199–206.
[17] Wei M-H, Toure O, Glenn GM et al. Novel mutations in FH and expansion of the spectrum of phenotypes expressed in families with hereditary leiomyomatosis and renal cell cancer. J Med Genet 2005; 43 (1): 18–27.
[18] Kuroda N, Ohe C, Kato I et al. Review of hereditary leiomyomatosis renal cell carcinoma with focus on clinical and pathobiological aspects of renal tumors. Pol J Pathol 2017; 68 (4): 284–90.
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  • APA Style

    Susana Medina-Montalvo, Ana Rodríguez-Villa Lario, José María Mesa-Latorre, Ana Vidal-Conde, Alba Gómez-Zubiaur, et al. (2021). Reed Syndrome in Eighteen Patients: A Genodermatosis Where Piloleiomyomas May Be the Diagnostic Clue. International Journal of Clinical Dermatology, 4(2), 16-22. https://doi.org/10.11648/j.ijcd.20210402.12

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    ACS Style

    Susana Medina-Montalvo; Ana Rodríguez-Villa Lario; José María Mesa-Latorre; Ana Vidal-Conde; Alba Gómez-Zubiaur, et al. Reed Syndrome in Eighteen Patients: A Genodermatosis Where Piloleiomyomas May Be the Diagnostic Clue. Int. J. Clin. Dermatol. 2021, 4(2), 16-22. doi: 10.11648/j.ijcd.20210402.12

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    AMA Style

    Susana Medina-Montalvo, Ana Rodríguez-Villa Lario, José María Mesa-Latorre, Ana Vidal-Conde, Alba Gómez-Zubiaur, et al. Reed Syndrome in Eighteen Patients: A Genodermatosis Where Piloleiomyomas May Be the Diagnostic Clue. Int J Clin Dermatol. 2021;4(2):16-22. doi: 10.11648/j.ijcd.20210402.12

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  • @article{10.11648/j.ijcd.20210402.12,
      author = {Susana Medina-Montalvo and Ana Rodríguez-Villa Lario and José María Mesa-Latorre and Ana Vidal-Conde and Alba Gómez-Zubiaur and Isabel Polo-Rodríguez and Ana Belén Piteriro-Bermejo and Dolores Vélez-Velázquez and Juan de Dios Garcia and Lidia Trasobares-Marugán},
      title = {Reed Syndrome in Eighteen Patients: A Genodermatosis Where Piloleiomyomas May Be the Diagnostic Clue},
      journal = {International Journal of Clinical Dermatology},
      volume = {4},
      number = {2},
      pages = {16-22},
      doi = {10.11648/j.ijcd.20210402.12},
      url = {https://doi.org/10.11648/j.ijcd.20210402.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20210402.12},
      abstract = {Introduction: Hereditary leiomyomatosis and renal cell cancer (HLRCC) is caused by germline heterozygous mutations of the fumarate hydratase (FH) gene. Materials and Methods: A retrospective observational study was conducted, aimed at characterizing the clinical features, histopathology, and genetic mutations in eighteen patients with confirmed HLRCC diagnosis. Results: FH gene mutations were identified in the seven families studied, including a previously undescribed mutation. All index cases of the families included were suspected on skin manifestations. Thirteen of the 18 patients (72%) presented cutaneous leiomyomas. The chief complaint was pain, with complete but transient response to botulinum toxin in one. No evidence of malignant transformation was observed. Uterine leiomyomas were present in seven of the eight women studied (88%). There was no evidence of renal cell carcinoma in any of the patients in the study. The most frequently found mutations were missense type (43%), followed by large rearrangements (24%), intronic deletions (14%) and nonsense (14%). A novel mutation not previously described in the literature is presented. Conclusions: HLRCC is a rare disease but it is also probably underdiagnosed. Dermatologists have an essential role in its diagnosis, by recognizing the clinical characteristics of the syndrome and investigating the family history.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Reed Syndrome in Eighteen Patients: A Genodermatosis Where Piloleiomyomas May Be the Diagnostic Clue
    AU  - Susana Medina-Montalvo
    AU  - Ana Rodríguez-Villa Lario
    AU  - José María Mesa-Latorre
    AU  - Ana Vidal-Conde
    AU  - Alba Gómez-Zubiaur
    AU  - Isabel Polo-Rodríguez
    AU  - Ana Belén Piteriro-Bermejo
    AU  - Dolores Vélez-Velázquez
    AU  - Juan de Dios Garcia
    AU  - Lidia Trasobares-Marugán
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    PY  - 2021
    N1  - https://doi.org/10.11648/j.ijcd.20210402.12
    DO  - 10.11648/j.ijcd.20210402.12
    T2  - International Journal of Clinical Dermatology
    JF  - International Journal of Clinical Dermatology
    JO  - International Journal of Clinical Dermatology
    SP  - 16
    EP  - 22
    PB  - Science Publishing Group
    SN  - 2995-1305
    UR  - https://doi.org/10.11648/j.ijcd.20210402.12
    AB  - Introduction: Hereditary leiomyomatosis and renal cell cancer (HLRCC) is caused by germline heterozygous mutations of the fumarate hydratase (FH) gene. Materials and Methods: A retrospective observational study was conducted, aimed at characterizing the clinical features, histopathology, and genetic mutations in eighteen patients with confirmed HLRCC diagnosis. Results: FH gene mutations were identified in the seven families studied, including a previously undescribed mutation. All index cases of the families included were suspected on skin manifestations. Thirteen of the 18 patients (72%) presented cutaneous leiomyomas. The chief complaint was pain, with complete but transient response to botulinum toxin in one. No evidence of malignant transformation was observed. Uterine leiomyomas were present in seven of the eight women studied (88%). There was no evidence of renal cell carcinoma in any of the patients in the study. The most frequently found mutations were missense type (43%), followed by large rearrangements (24%), intronic deletions (14%) and nonsense (14%). A novel mutation not previously described in the literature is presented. Conclusions: HLRCC is a rare disease but it is also probably underdiagnosed. Dermatologists have an essential role in its diagnosis, by recognizing the clinical characteristics of the syndrome and investigating the family history.
    VL  - 4
    IS  - 2
    ER  - 

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Author Information
  • Department of Dermatology, Prince of Asturias Universitary Hospital, University of Alcalá, Madrid, Spain

  • Department of Dermatology, Prince of Asturias Universitary Hospital, University of Alcalá, Madrid, Spain

  • Department of Internal Medicine, Prince of Asturias Universitary Hospital, Madrid, Spain

  • Department of Anesthesiology, Prince of Asturias Universitary Hospital, Madrid, Spain

  • Department of Dermatology, Prince of Asturias Universitary Hospital, University of Alcalá, Madrid, Spain

  • Department of Dermatology, Prince of Asturias Universitary Hospital, University of Alcalá, Madrid, Spain

  • Department of Dermatology, Prince of Asturias Universitary Hospital, University of Alcalá, Madrid, Spain

  • Department of Pathology Prince of Asturias Universitary Hospital, Madrid, Spain

  • Department of Internal Medicine, Prince of Asturias Universitary Hospital, Madrid, Spain

  • Department of Dermatology, Prince of Asturias Universitary Hospital, University of Alcalá, Madrid, Spain

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