Mapping the Somatic Mutation Landscape of Familial NF2-Related Schwannomatosis using Whole-Exome Sequencing

Background: Neurofibromatosis type 2 (NF2), currently more accurately named NF2-related schwannomatosis (NF2-SWN), is classified as a multiple tumor syndrome, caused by impaired expression of the merlin protein. Approximately 50% of affected individuals inherit a germline mutation from their parents, while reports on the somatic mutation landscape of other genes are infrequent. Aim: To further explore the somatic mutations of NF2-SWN and provide a theoretical basis for the treatment of NF2-SWN. Design: A retrospective study was conducted to follow up on NF2-SWN patients who underwent surgical treatment in the Department of Neurosurgery of Xiangya Hospital. Whole-exome sequencing (WES) was performed on patients with a clear family history. Methods: This study compiled clinical data from 29 patients diagnosed with NF2-SWN, conducted WES on 7 patients with well-documented genetic histories, and subsequently analyzed their genetic mutations. Results: Whole-exome sequencing identified frequent somatic mutations in genes such as TTN, FLG, CR2, and FSIP2. Missense mutations and C>T transitions were the most common alteration types. Conclusion: TTN, CR2, FLG, and FSIP2 demonstrated elevated mutation frequencies in these familial NF2-SWN patients, indicating that these mutations may contribute to the development and progression of familial NF2-SWN.