Katie S Murray1, Massimiliano Spaliviero2, Emily S Tonorezos3, Mario E Lacouture4, William D Tap5, Kevin C Oeffinger6, Hebert Alberto Vargas7, James A Eastham8. 1. Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Surgery, Division of Urology, University of Missouri, Columbia, MO. Electronic address: murraykat@health.missouri.edu. 2. Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Stony Brook Medicine, SUNY at Stony Brook, Stony Brook, NY. 3. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell Medical College, New York, NY. 4. Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, NY. 5. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY. 6. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY; Duke Cancer Institute, Durham, NC. 7. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY. 8. Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell Medical College, New York, NY.
Abstract
OBJECTIVE: To report a case of pelvic angiosarcoma in a 27-year-old man with Li-Fraumeni Syndrome (LFS) and evaluate the presentation and timeline of genitourinary (GU) tract involvement in LFS patients. METHODS: We retrospectively identified 39 LFS patients treated at our institution between 2000 and 2014; 7 (18%) had experienced a GU malignancy or an LFS-related malignancy involving the GU tract. Clinical characteristics, including dates of onset of first GU tract malignancies; pathologic findings; multimodal management; and familial history of LFS were reviewed. RESULTS: Median age at first malignancy was 14.0 years (interquartile range [IQR] 5.5-24.0). There was a slight male predominance (4 of 7). Median time between first malignancy and the malignancy involving the GU tract was 10.1 years (IQR 8.0-19.5). Six of the 7 patients (86%) had a form of sarcoma involving the GU tract; 1 developed adrenocortical carcinoma. The cancer pedigree of all patients showed LFS-associated malignancies in family members. Multimodal management included surgical resection in 6 patients with adjuvant chemotherapy or radiotherapy in 1 patient each. One patient received chemotherapy only. Following diagnosis of malignancy involving the GU tract, 5 of the 7 patients developed additional primary malignancies. At a median follow-up of 4.7 years (IQR 3.0-12.1), 2 patients are alive, 3 died of disease, and 1 died of unknown cause. One patient was lost at follow-up. CONCLUSION: Continued follow-up of LFS cancer patients aimed at the determination of optimal screening, management, and surveillance protocols is recommended and may result in longer survival expectations.
OBJECTIVE: To report a case of pelvic angiosarcoma in a 27-year-old man with Li-Fraumeni Syndrome (LFS) and evaluate the presentation and timeline of genitourinary (GU) tract involvement in LFSpatients. METHODS: We retrospectively identified 39 LFSpatients treated at our institution between 2000 and 2014; 7 (18%) had experienced a GU malignancy or an LFS-related malignancy involving the GU tract. Clinical characteristics, including dates of onset of first GU tract malignancies; pathologic findings; multimodal management; and familial history of LFS were reviewed. RESULTS: Median age at first malignancy was 14.0 years (interquartile range [IQR] 5.5-24.0). There was a slight male predominance (4 of 7). Median time between first malignancy and the malignancy involving the GU tract was 10.1 years (IQR 8.0-19.5). Six of the 7 patients (86%) had a form of sarcoma involving the GU tract; 1 developed adrenocortical carcinoma. The cancer pedigree of all patients showed LFS-associated malignancies in family members. Multimodal management included surgical resection in 6 patients with adjuvant chemotherapy or radiotherapy in 1 patient each. One patient received chemotherapy only. Following diagnosis of malignancy involving the GU tract, 5 of the 7 patients developed additional primary malignancies. At a median follow-up of 4.7 years (IQR 3.0-12.1), 2 patients are alive, 3 died of disease, and 1 died of unknown cause. One patient was lost at follow-up. CONCLUSION: Continued follow-up of LFS cancerpatients aimed at the determination of optimal screening, management, and surveillance protocols is recommended and may result in longer survival expectations.
Authors: D W Bell; J M Varley; T E Szydlo; D H Kang; D C Wahrer; K E Shannon; M Lubratovich; S J Verselis; K J Isselbacher; J F Fraumeni; J M Birch; F P Li; J E Garber; D A Haber Journal: Science Date: 1999-12-24 Impact factor: 47.728
Authors: J M Birch; R D Alston; R J McNally; D G Evans; A M Kelsey; M Harris; O B Eden; J M Varley Journal: Oncogene Date: 2001-08-02 Impact factor: 9.867
Authors: Neil Senzer; John Nemunaitis; Michael Nemunaitis; Jeffrey Lamont; Martin Gore; Hani Gabra; Rosalind Eeles; Nayanta Sodha; Frank J Lynch; Louis A Zumstein; Kerstin B Menander; Robert E Sobol; Sunil Chada Journal: Mol Cancer Ther Date: 2007-05-04 Impact factor: 6.261
Authors: Kelly D Gonzalez; Katie A Noltner; Carolyn H Buzin; Dongqing Gu; Cindy Y Wen-Fong; Vu Q Nguyen; Jennifer H Han; Katrina Lowstuter; Jeffrey Longmate; Steve S Sommer; Jeffrey N Weitzel Journal: J Clin Oncol Date: 2009-02-09 Impact factor: 44.544
Authors: D Malkin; F P Li; L C Strong; J F Fraumeni; C E Nelson; D H Kim; J Kassel; M A Gryka; F Z Bischoff; M A Tainsky Journal: Science Date: 1990-11-30 Impact factor: 47.728