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Germline mutations associated with pheochromocytoma and paraganglioma

Germline mutations associated with pheochromocytoma and paraganglioma
Syndrome/name Gene Typical tumor location and other associations
Hypoxic pathway – Cluster 1*
SDHD mutation (familial paraganglioma type 1) SDHD Primarily skull base and neck; occasionally adrenal medulla, mediastinum, abdomen, pelvis; GIST; possible pituitary adenoma
SDHAF2 mutation (familial paraganglioma type 2) SDHAF2 Primarily skull base and neck; occasionally abdomen and pelvis
SDHC mutation (familial paraganglioma type 3) SDHC Primarily skull base and neck; occasionally abdomen and pelvis; GIST; possible pituitary adenoma
SDHB mutation (familial paraganglioma type 4) SDHB Abdomen, pelvis and mediastinum; rarely adrenal medulla, skull base, and neck; GIST; possible pituitary adenoma
SDHA mutation SDHA Primarily skull base and neck; occasionally abdomen and pelvis; GIST; possible pituitary adenoma
VHL disease VHL Adrenal medulla, frequently bilateral; occasionally paraganglioma that may be localized from skull base to pelvis
Hereditary leiomyomatosis and renal cell carcinoma (Reed syndrome) – Fumarate hydratase mutation FH Multifocal and metastatic; associated with hereditary leiomyomatosis, uterine fibroids, and renal cell cancer
Hypoxia inducible factor 2-alpha HIF-2α Paraganglioma, polycythemia, and rarely somastostatinoma
Familial erythrocytosis associated with mutation in prolyl hydroxylase isoform 1 (PDH1) EGLN2 Polycythemia associated with pheochromocytoma and paraganglioma
Familial erythrocytosis associated with mutation in prolyl hydroxylase isoform 2 (PDH2) EGLN1 Polycythemia associated with pheochromocytoma and paraganglioma
KIF1B KIF1B Neuroblastoma
Kinase signaling pathway – Cluster 2Δ
MEN2A and MEN2B RET Adrenal medulla, frequently bilateral
Neurofibromatosis type 1 NF1 Adrenal or peri-adrenal
MAX MAX Adrenal medulla
Familial pheochromocytoma TMEM127 Adrenal medulla; possible renal cell carcinoma
GIST: gastrointestinal stromal tumor; MEN2: multiple endocrine neoplasia type 2; SDH: succinate dehydrogenase; VHL: von Hippel-Lindau.
* Cluster 1 tumors are mostly extra-adrenal paragangliomas (except in VHL, where most tumors are localized to the adrenal), and nearly all have a noradrenergic biochemical phenotype.
¶ Associated with maternal imprinting.
Δ Cluster 2 tumors are usually adrenal pheochromocytomas with an adrenergic biochemical phenotype.
Original figure modified for this publication. Young WF. Endocrine hypertension. In: Williams Textbook of Endocrinology, Melmed S, Polonsky KS, Larsen PR, Kronenberg HM (Eds), 13th ed, Elsevier Inc, Philadelphia 2015. p.556. Table used with the permission of Elsevier Inc. All rights reserved.
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