Aggressive prolactinoma in a child related to germline mutation in the ARYL hydrocarbon receptor interacting protein

Luciana Ansaneli Naves1, Marie-Lise Jaffrain-Rea, Sergio Alberto Cunha Vêncio

  • 1Endocrinology Unit, Universidade de Brasília, DF, Brazil. draluciananaves@gmail.com

Insights

A familial screening identified a pituitary tumor gene mutation (AIP) in a child with aggressive prolactinoma. This AIP gene mutation may predispose young patients to developing aggressive pituitary adenomas.

Area of Science:

  • Endocrinology
  • Genetics
  • Pediatric Oncology

Background:

  • Pituitary adenomas are rare in children, and aggressive forms present unique challenges.
  • Familial screening for genetic predispositions is crucial for understanding tumor pathogenesis.

Observation:

  • A 12-year-old boy presented with a large, aggressive pituitary macroadenoma causing visual deficits and hormonal imbalances.
  • The tumor showed resistance to standard treatment (cabergoline), necessitating multiple surgeries and radiotherapy.
  • Immunohistochemical analysis and genomic DNA sequencing were performed on the patient and 48 relatives.

Findings:

  • A germline A195V mutation in the Aryl hydrocarbon receptor-Interacting Protein (AIP) gene was identified in the patient.
  • The same AIP mutation was found in five asymptomatic relatives, suggesting a hereditary predisposition.
  • This mutation was linked to the aggressive nature of the prolactinoma in the pediatric patient.

Implications:

  • Germline AIP mutations may play a significant role in the development of aggressive pituitary adenomas in young individuals.
  • Identifying AIP mutations can aid in early diagnosis and risk assessment for familial pituitary tumor syndromes.
  • Understanding the genetic basis of aggressive pituitary tumors can inform targeted therapeutic strategies.

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