Skip to main content
Top
Published in: BMC Medical Genetics 1/2015

Open Access 01-12-2015 | Case report

Spinal ependymoma in a patient with Kabuki syndrome: a case report

Authors: Davide Roma, Paolo Palma, Rossella Capolino, Lorenzo Figà-Talamanca, Francesca Diomedi-Camassei, Francesca Romana Lepri, Maria Cristina Digilio, Carlo Efisio Marras, Raffaella Messina, Andrea Carai, Franco Randi, Angela Mastronuzzi

Published in: BMC Medical Genetics | Issue 1/2015

Login to get access

Abstract

Background

Kabuki syndrome is a rare disorder characterized by the association of mental retardation and postnatal growth deficiency with distinctive facial appearance, skeletal anomalies, cardiac and renal malformation. Two causative genes have been identified in patients with Kabuki syndrome. Mutation of KMT2D (MLL2) was identified in 55–80 % of patients, while 9–14 % of KMT2D negative patients have mutation in KDM6A gene. So far, few tumors have been reported in patients with Kabuki syndrome. We describe the first case of a patient with spinal ependymoma and Kabuki syndrome.

Case presentation

A 23 years old girl followed at our Center for KMT2D mutated Kabuki syndrome since she was 4 years old presented with acute lumbar pain and intermittent tactile hyposthenia of the feet. Spine magnetic resonance revealed a lumbar endocanalar mass. She underwent surgical resection of the lesion and histologic examination showed a tanycytic ependymoma (WHO grade II).

Conclusion

Kabuki syndrome is not considered a cancer predisposition syndrome. Nonetheless, a number of tumors have been reported in patients with Kabuki syndrome. Spinal ependymoma is a rare disease in the pediatric and young adult population. Whereas NF2 mutations are frequently associated to ependymoma such an association has never been described in Kabuki syndrome. To our knowledge this is the first case of ependymoma in a KMT2D mutated Kabuki syndrome patient. Despite KMT2D role in cancer has previously been described, no genetic data are available for previously reported Kabuki syndrome patients with tumors. Nonetheless, the association of two rare diseases raises the suspicion for a common determinant.
Literature
1.
go back to reference Niikawa N, Kuroki Y, Kajii T, Matsuura N, Ishikiriyama S, Tonoki H, et al. Kabuki make-up (Niikawa-Kuroki) syndrome: a study of 62 patients. Am J Med Genet. 1988;31(3):565–89.CrossRefPubMed Niikawa N, Kuroki Y, Kajii T, Matsuura N, Ishikiriyama S, Tonoki H, et al. Kabuki make-up (Niikawa-Kuroki) syndrome: a study of 62 patients. Am J Med Genet. 1988;31(3):565–89.CrossRefPubMed
2.
go back to reference Kuroki Y, Suzuki Y, Chyo H, Hata A, Matsui I. A new malformation syndrome of long palpebral fissures, large ears, depressed nasal tip, and skeletal anomalies associated with postnatal dwarfism and mental retardation. J Pediatr. 1981;99:570–3.CrossRefPubMed Kuroki Y, Suzuki Y, Chyo H, Hata A, Matsui I. A new malformation syndrome of long palpebral fissures, large ears, depressed nasal tip, and skeletal anomalies associated with postnatal dwarfism and mental retardation. J Pediatr. 1981;99:570–3.CrossRefPubMed
4.
go back to reference Ng SB, Bigham AW, Buckingham KJ, Hannibal MC, McMillin MJ, Gildersleeve HI, et al. Exome sequencing identifies MLL2 mutations as a cause of Kabuki syndrome. Nat Genet. 2010;42(9):790–3.CrossRefPubMedPubMedCentral Ng SB, Bigham AW, Buckingham KJ, Hannibal MC, McMillin MJ, Gildersleeve HI, et al. Exome sequencing identifies MLL2 mutations as a cause of Kabuki syndrome. Nat Genet. 2010;42(9):790–3.CrossRefPubMedPubMedCentral
5.
go back to reference Dentici ML, Di Pede A, Lepri FR, Gnazzo M, Lombardi MH, Auriti C, et al. Kabuki syndrome: clinical and molecular diagnosis in the first year of life. Arch Dis Child. 2015;100(2):158–64.CrossRefPubMed Dentici ML, Di Pede A, Lepri FR, Gnazzo M, Lombardi MH, Auriti C, et al. Kabuki syndrome: clinical and molecular diagnosis in the first year of life. Arch Dis Child. 2015;100(2):158–64.CrossRefPubMed
6.
go back to reference Merks JH, Caron HN, Hennekam RC. High incidence of malformation syndromes in a series of 1073 children with cancer. Am J Med Genet A. 2005;134A:132–43.CrossRefPubMed Merks JH, Caron HN, Hennekam RC. High incidence of malformation syndromes in a series of 1073 children with cancer. Am J Med Genet A. 2005;134A:132–43.CrossRefPubMed
7.
go back to reference Tumino M, Licciardello M, Sorge G, Cutrupi MC, Di Benedetto F, Amoroso L, et al. Kabuki syndrome and cancer in two patients. Am J Med Genet A. 2010;152A:1536–9.PubMed Tumino M, Licciardello M, Sorge G, Cutrupi MC, Di Benedetto F, Amoroso L, et al. Kabuki syndrome and cancer in two patients. Am J Med Genet A. 2010;152A:1536–9.PubMed
8.
go back to reference Scherer S, Theile U, Beyer V, Ferrari R, Kreck C, Rister M. Patient with Kabuki syndrome and acute leukemia. Am J Med Genet A. 2003;122A:76–9.CrossRefPubMed Scherer S, Theile U, Beyer V, Ferrari R, Kreck C, Rister M. Patient with Kabuki syndrome and acute leukemia. Am J Med Genet A. 2003;122A:76–9.CrossRefPubMed
9.
go back to reference Ijichi O, Kawakami K, Matsuda Y, Ikarimoto N, Miyata K, Takamatsu H, et al. A case of Kabuki make-up syndrome with EBV + Burkitt’s lymphoma. Acta Paediatr Jpn. 1996;38:66–8.CrossRefPubMed Ijichi O, Kawakami K, Matsuda Y, Ikarimoto N, Miyata K, Takamatsu H, et al. A case of Kabuki make-up syndrome with EBV + Burkitt’s lymphoma. Acta Paediatr Jpn. 1996;38:66–8.CrossRefPubMed
10.
go back to reference Shahdadpuri R, O’Meara A, O’Sullivan M, Reardon W. Low-grade fibromyxoid sarcoma: yet another malignancy associated with Kabuki syndrome. Clin Dysmorphol. 2008;17:199–202.CrossRefPubMed Shahdadpuri R, O’Meara A, O’Sullivan M, Reardon W. Low-grade fibromyxoid sarcoma: yet another malignancy associated with Kabuki syndrome. Clin Dysmorphol. 2008;17:199–202.CrossRefPubMed
11.
go back to reference Casanova M, Selicorni A, Ferrari A. Cancer predisposition in children with Kabuki syndrome. Am J Med Genet A. 2011;155A:1504.CrossRefPubMed Casanova M, Selicorni A, Ferrari A. Cancer predisposition in children with Kabuki syndrome. Am J Med Genet A. 2011;155A:1504.CrossRefPubMed
12.
go back to reference Kuttesh JF, Zieber Rush S, Ater JL. Brain tumors in childhood. In: Kliegman RM, Behrman RE, Stanton BF, St. Geme III JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011. p. 1746–53.CrossRef Kuttesh JF, Zieber Rush S, Ater JL. Brain tumors in childhood. In: Kliegman RM, Behrman RE, Stanton BF, St. Geme III JW, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011. p. 1746–53.CrossRef
13.
go back to reference Ailon T, Dunham C, Carret AS, Tabori U, Mcneely PD, Zelcer S, et al. The role of resection alone in select children with intracranial ependymoma: the Canadian Pediatric Brain Tumour Consortium experience. Childs Nerv Syst. 2015;31(1):57–65.CrossRefPubMed Ailon T, Dunham C, Carret AS, Tabori U, Mcneely PD, Zelcer S, et al. The role of resection alone in select children with intracranial ependymoma: the Canadian Pediatric Brain Tumour Consortium experience. Childs Nerv Syst. 2015;31(1):57–65.CrossRefPubMed
14.
15.
16.
go back to reference Guo C, Chen LH, Huang Y, Chang CC, Wang P, Pirozzi CJ, et al. KMT2D maintains neoplastic cell proliferation and global histone H3 lysine 4 monomethylation. Oncotarget. 2013;4(11):2144–53.CrossRefPubMedPubMedCentral Guo C, Chen LH, Huang Y, Chang CC, Wang P, Pirozzi CJ, et al. KMT2D maintains neoplastic cell proliferation and global histone H3 lysine 4 monomethylation. Oncotarget. 2013;4(11):2144–53.CrossRefPubMedPubMedCentral
17.
go back to reference Ali M, Hom RA, Blakeslee W, Ikenouye L, Kutateladze TG. Diverse functions of PHD fingers of the MLL/KMT2 subfamily. Biochim Biophys Acta. 2014;1843(2):366–71.CrossRefPubMed Ali M, Hom RA, Blakeslee W, Ikenouye L, Kutateladze TG. Diverse functions of PHD fingers of the MLL/KMT2 subfamily. Biochim Biophys Acta. 2014;1843(2):366–71.CrossRefPubMed
18.
go back to reference Dhar SS, Lee SH, Kan PY, Voigt P, Ma L, Shi X, et al. Trans-tail regulation of MLL4-catalyzed H3K4 methylation by H4R3 symmetric dimethylation is mediated by a tandem PHD of MLL4. Genes Dev. 2012;26:2749–62.CrossRefPubMedPubMedCentral Dhar SS, Lee SH, Kan PY, Voigt P, Ma L, Shi X, et al. Trans-tail regulation of MLL4-catalyzed H3K4 methylation by H4R3 symmetric dimethylation is mediated by a tandem PHD of MLL4. Genes Dev. 2012;26:2749–62.CrossRefPubMedPubMedCentral
19.
go back to reference Zemmoura I, Vourc’h P, Paubel A, Ikenouye L, Kutateladze TG. A deletion causing NF2 exon 9 skipping is associated with familial autosomal dominant intramedullary ependymoma. Neuro Oncol. 2014;16(2):250–5.CrossRefPubMed Zemmoura I, Vourc’h P, Paubel A, Ikenouye L, Kutateladze TG. A deletion causing NF2 exon 9 skipping is associated with familial autosomal dominant intramedullary ependymoma. Neuro Oncol. 2014;16(2):250–5.CrossRefPubMed
Metadata
Title
Spinal ependymoma in a patient with Kabuki syndrome: a case report
Authors
Davide Roma
Paolo Palma
Rossella Capolino
Lorenzo Figà-Talamanca
Francesca Diomedi-Camassei
Francesca Romana Lepri
Maria Cristina Digilio
Carlo Efisio Marras
Raffaella Messina
Andrea Carai
Franco Randi
Angela Mastronuzzi
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Medical Genetics / Issue 1/2015
Electronic ISSN: 1471-2350
DOI
https://doi.org/10.1186/s12881-015-0228-4

Other articles of this Issue 1/2015

BMC Medical Genetics 1/2015 Go to the issue