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The most recent version of this article was published on 1 October 2008

J Med Genet. Published Online First: 2 May 2008. doi:10.1136/jmg.2008.058131
Copyright © 2008 by the BMJ Publishing Group Ltd.

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Short Report

Contribution of PTEN large rearrangements in Cowden disease: a MAPH screening approach

Frederic Chibon 1, Charlotte Primois 1, Jean-Marc Bressieux 2, Didier Lacombe 3, Catherine Lok 4, Louis Mauriac 5, Alain Taieb 6 and Michel Longy 7*

1 Laboratoire de Genetique Moleculaire, Institut Bergonie, Bordeaux, France
2 Service de Dermatologie, Centre Hospitalier, Troyes, France
3 Service de Genetique Medicale,CHU et EA 3669, universite Victor Segalen-Bordeaux 2, Bordeaux, France
4 Service de Dermatologie, Centre Hospitalier Universitaire Sud, Amiens, France
5 Departement d'Oncologie medicale, Institut Bergonie, Bordeaux, France
6 Service de Dermatologie et de Dermatologie Pediatrique, Centre Hospitalier Universitaire, Bordeaux, France
7 Genetique Moleculaire, Institut Bergonie et EA 3669, Universite Victor Segalen-Bordeaux 2, Bordeaux, France

* To whom correspondence should be addressed. E-mail: longy{at}bergonie.org.

Accepted 10 April 2008


*   Abstract

Background: Cowden disease is an autosomal dominant syndrome predisposing to cancer and characterized by the occurrence throughout life of hyperplastic, hamartomatous and tumoral lesions affecting various organs. In 60% to 80% of patients a germline intragenic point mutation of the PTEN tumor suppressor gene is identified but at least 20% of patients with a well characterized phenotype remain without any identified mutation.

Methods: To evaluate the impact of large rearrangement involving the PTEN locus in Cowden disease, we analysed by a Multiplex Amplifiable Probe Hybridization (MAPH) technique 80 unrelated patients referred for diagnosed or suspected Cowden disease, and in whom no PTEN point mutation was detected by a denaturing gradient gel electrophoresis (DGGE) screening.

Results: Four heterozygous genomic deletions involving the PTEN gene were identified. These deletions ranged from 13.6 kb to 662 kb and are restricted to the PTEN locus in two cases. In the two other cases, the deletion encompassed PTEN and either two or three contiguous genes without any obvious phenotypic effect except a possible consequence of ATAD1 haplo-insufficiency on bone growth. Sequence analysis of the four deleted alleles did not reveal identity or sequence homology at the two breakpoints of a same allele, suggesting that a mechanism such as non-homologous recombination of the breakage and reunion type could lead to the occurrence of these deletions.

Conclusion: Large rearrangements of the PTEN gene can be involved as causing mutation in Cowden disease and MAPH is an efficient screening methodology to detect such a genetic alteration.








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