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      Benign and malignant tumors in Rubinstein–Taybi syndrome

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          Abstract

          Rubinstein–Taybi syndrome (RSTS) is a multiple congenital anomalies syndrome associated with mutations in CREBBP (70%) and EP300 (5–10%). Previous reports have suggested an increased incidence of specific benign and possibly also malignant tumors. We identified all known individuals diagnosed with RSTS in the Netherlands until 2015 ( n = 87) and studied the incidence and character of neoplastic tumors in relation to their CREBBP/ EP300 alterations. The population–based Dutch RSTS data are compared to similar data of the Dutch general population and to an overview of case reports and series of all RSTS individuals with tumors reported in the literature to date. Using the Nationwide Network and Registry of Histopathology and Cytopathology in the Netherlands (PALGA Foundation), 35 benign and malignant tumors were observed in 26/87 individuals. Meningiomas and pilomatricomas were the most frequent benign tumors and their incidence was significantly elevated in comparison to the general Dutch population. Five malignant tumors were observed in four persons with RSTS (medulloblastoma; diffuse large‐cell B‐cell lymphoma; breast cancer; non‐small cell lung carcinoma; colon carcinoma). No clear genotype–phenotype correlation became evident. The Dutch population‐based data and reported case studies underscore the increased incidence of meningiomas and pilomatricomas in individuals with RSTS. There is no supporting evidence for an increased risk for malignant tumors in individuals with RSTS, however, due to the small numbers this risk may not be fully dismissed.

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          Most cited references68

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          Pathology Databanking and Biobanking in The Netherlands, a Central Role for PALGA, the Nationwide Histopathology and Cytopathology Data Network and Archive

          Since 1991, a nationwide histopathology and cytopathology network and archive is in operation in The Netherlands under the name PALGA, encompassing all sixty-four pathology laboratories in The Netherlands. The overall system comprises decentralized systems at the participating laboratories, a central databank, and a dedicated communication and information exchange tool. Excerpts of all histopathology and cytopathology reports are generated automatically at the participating laboratories and transferred to the central databank. Both the decentralized systems and the central system perform checks on the quality and completeness of excerpts. Currently, about 42 million records on almost 10 million patients are stored in the central databank. Each excerpt contains patient identifiers, including demographic data and the so-called PALGA diagnosis. The latter is structured along five classification axes: topography, morphology, function, procedure, and diseases. All data transfer and communication occurs electronically with encryption of patient and laboratory identifiers. All excerpts are continuously available to all participating pathology laboratories, thus contributing to the quality of daily patient care. In addition, external parties may obtain permission to use data from the PALGA system, either on an ongoing basis or on the basis of a specific permission. Annually, 40 to 60 applications for permission to use PALGA data are submitted. Among external users are the Dutch cancer registry, population-based screening programs for cancer of the uterine cervix and breast cancer in The Netherlands, and individual investigators addressing a range of research questions. Many scientific papers and theses incorporating PALGA data have been published already. In conclusion, the PALGA system is a unique system that requires a minimal effort on the part of the participating laboratories, while providing them a powerful tool in their daily practices.
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            Epidemiology and etiology of meningioma

            Although most meningiomas are encapsulated and benign tumors with limited numbers of genetic aberrations, their intracranial location often leads to serious and potentially lethal consequences. They are the most frequently diagnosed primary brain tumor accounting for 33.8% of all primary brain and central nervous system tumors reported in the United States between 2002 and 2006. Inherited susceptibility to meningioma is suggested both by family history and candidate gene studies in DNA repair genes. People with certain mutations in the neurofibromatosis gene (NF2) have a very substantial increased risk for meningioma. High dose ionizing radiation exposure is an established risk factor for meningioma, and lower doses may also increase risk, but which types and doses are controversial or understudied. Because women are twice as likely as men to develop meningiomas and these tumors harbor hormone receptors, an etiologic role for hormones (both endogenous and exogenous) has been hypothesized. The extent to which immunologic factors influence meningioma etiology has been largely unexplored. Growing emphasis on brain tumor research coupled with the advent of new genetic and molecular epidemiologic tools in genetic and molecular epidemiology promise hope for advancing knowledge about the causes of intra-cranial meningioma. In this review, we highlight current knowledge about meningioma epidemiology and etiology and suggest future research directions.
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              Rubinstein-Taybi syndrome caused by mutations in the transcriptional co-activator CBP.

              The Rubinstein-Taybi syndrome (RTS) is a well-defined syndrome with facial abnormalities, broad thumbs, broad big toes and mental retardation as the main clinical features. Many patients with RTS have been shown to have breakpoints in, and microdeletions of, chromosome 16p13.3 (refs 4-8). Here we report that all these breakpoints are restricted to a region that contains the gene for the human CREB binding protein (CBP), a nuclear protein participating as a co-activator in cyclic-AMP-regulated gene expression. We show that RTS results not only from gross chromosomal rearrangements of chromosome 16p, but also from point mutations in the CBP gene itself. Because the patients are heterozygous for the mutations, we propose that the loss of one functional copy of the CBP gene underlies the developmental abnormalities in RTS and possibly the propensity for malignancy.
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                Author and article information

                Contributors
                r.c.hennekam@amc.uva.nl
                Journal
                Am J Med Genet A
                Am. J. Med. Genet. A
                10.1002/(ISSN)1552-4833
                AJMG
                American Journal of Medical Genetics. Part a
                John Wiley and Sons Inc. (Hoboken )
                1552-4825
                1552-4833
                23 January 2018
                March 2018
                : 176
                : 3 ( doiID: 10.1002/ajmg.a.v176.3 )
                : 597-608
                Affiliations
                [ 1 ] Department of Pathology VU University Medical Centre Amsterdam The Netherlands
                [ 2 ] Department of Clinical Genetics Leiden University Medical Centre Leiden The Netherlands
                [ 3 ] Dutch Pathology Registry Houten The Netherlands
                [ 4 ] Department of Clinical Genetics VU University Medical Centre Amsterdam The Netherlands
                [ 5 ] Department of Pathology, Princess Máxima Centre for Pediatric Oncology Utrecht and University Medical Centre Utrecht Utrecht The Netherlands
                [ 6 ] Department of Pediatrics Amsterdam University Medical Centre Amsterdam The Netherlands
                Author notes
                [*] [* ] Correspondence

                Raoul C. Hennekam, Department of Pediatrics, H7‐236, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam 1105AZ, The Netherlands.

                Email: r.c.hennekam@ 123456amc.uva.nl

                Author information
                http://orcid.org/0000-0002-2992-9599
                Article
                AJMGA38603
                10.1002/ajmg.a.38603
                5838508
                29359884
                11d1d2cf-e8f0-4617-b0f8-a85cd7b1f42f
                © 2018 The Authors. American Journal of Medical Genetics Part A Published by Wiley Periodicals, Inc.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 27 September 2017
                : 11 December 2017
                : 20 December 2017
                Page count
                Figures: 2, Tables: 2, Pages: 12, Words: 5938
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                ajmga38603
                March 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.2.2 mode:remove_FC converted:06.03.2018

                Genetics
                crebbp,diffuse large b‐cell lymphoma,ep300,meningioma,neoplasia,rubinstein–taybi syndrome
                Genetics
                crebbp, diffuse large b‐cell lymphoma, ep300, meningioma, neoplasia, rubinstein–taybi syndrome

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